Healthcare Provider Details

I. General information

NPI: 1962448605
Provider Name (Legal Business Name): JOHN C TOOLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 W VIRGINIA AVE
TAMPA FL
33607-6330
US

IV. Provider business mailing address

4902 EISENHOWER BLVD SUITE 300
TAMPA FL
33634-6344
US

V. Phone/Fax

Practice location:
  • Phone: 813-875-9000
  • Fax: 813-874-3278
Mailing address:
  • Phone: 813-636-2000
  • Fax: 813-874-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME26603
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME26603
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberME26603
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: