Provider Demographics
NPI:1104116631
Name:FOX, JENNIFER MELISSA LEE (DPM)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:MELISSA LEE
Last Name:FOX
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:PO BOX 605
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34451-0605
Mailing Address - Country:US
Mailing Address - Phone:352-476-3089
Mailing Address - Fax:
Practice Address - Street 1:131 S CITRUS AVE STE 300
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4701
Practice Address - Country:US
Practice Address - Phone:352-341-6000
Practice Address - Fax:352-341-6160
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO3648213ES0103X
NY006555213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery