Healthcare Provider Details

I. General information

NPI: 1043471428
Provider Name (Legal Business Name): THOMAS O PEARSON PENN-TAMPA NEUROLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2008
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35111 US HIGHWAY 19 N
PALM HARBOR FL
34684-1935
US

IV. Provider business mailing address

35111 US HIGHWAY 19 N STE 207
PALM HARBOR FL
34684-1935
US

V. Phone/Fax

Practice location:
  • Phone: 727-771-1818
  • Fax:
Mailing address:
  • Phone: 727-599-4705
  • Fax: 727-279-4784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number StateFL

VIII. Authorized Official

Name: DR. THOMAS O PEARSON
Title or Position: OWNER
Credential: MD
Phone: 717-994-7470