Healthcare Provider Details

I. General information

NPI: 1790743573
Provider Name (Legal Business Name): TOM R. KARL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 12/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 5TH ST S STE 601
SAINT PETERSBURG FL
33701-4804
US

IV. Provider business mailing address

601 5TH ST S STE 601
SAINT PETERSBURG FL
33701-4804
US

V. Phone/Fax

Practice location:
  • Phone: 727-898-7451
  • Fax:
Mailing address:
  • Phone: 727-898-7451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA41242
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA41242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: