Healthcare Provider Details

I. General information

NPI: 1316870637
Provider Name (Legal Business Name): TOMARCHIO MEDICAL GROUP, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19817 GULF BLVD APT 301
INDIAN SHORES FL
33785-2396
US

IV. Provider business mailing address

19817 GULF BLVD APT 301
INDIAN SHORES FL
33785-2396
US

V. Phone/Fax

Practice location:
  • Phone: 803-335-8857
  • Fax:
Mailing address:
  • Phone: 803-335-8857
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN BRANHAM TOMARCHIO
Title or Position: OWNER
Credential:
Phone: 803-335-8857