Healthcare Provider Details

I. General information

NPI: 1265669238
Provider Name (Legal Business Name): JEREMY L THARP M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2009
Last Update Date: 10/22/2025
Certification Date: 10/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 MEDICAL BLVD STE 102
SPRING HILL FL
34609-0221
US

IV. Provider business mailing address

14690 SPRING HILL DR STE 305
SPRING HILL FL
34609-8102
US

V. Phone/Fax

Practice location:
  • Phone: 352-686-0086
  • Fax: 352-684-2081
Mailing address:
  • Phone: 352-277-5348
  • Fax: 352-606-2857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME108515
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: