Provider Demographics
NPI:1770223752
Name:IRANMANESH, NIKI (DPM)
Entity type:Individual
Prefix:DR
First Name:NIKI
Middle Name:
Last Name:IRANMANESH
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408 W REYNOLDS ST
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33563-4361
Mailing Address - Country:US
Mailing Address - Phone:813-733-5926
Mailing Address - Fax:833-382-1910
Practice Address - Street 1:1408 W REYNOLDS ST
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-4361
Practice Address - Country:US
Practice Address - Phone:813-733-5926
Practice Address - Fax:833-382-1910
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO4672213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist