Healthcare Provider Details

I. General information

NPI: 1689085961
Provider Name (Legal Business Name): PASQUALE GIACOMO TOLOMEO MD, DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2014
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17751 GUNN HWY
ODESSA FL
33556-1912
US

IV. Provider business mailing address

4047 GAUGE LINE LOOP
TAMPA FL
33624-5129
US

V. Phone/Fax

Practice location:
  • Phone: 813-836-7202
  • Fax:
Mailing address:
  • Phone: 516-279-7611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDN29966
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberME158163
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: