Healthcare Provider Details

I. General information

NPI: 1790771970
Provider Name (Legal Business Name): THOMAS M. KERR MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2005
Last Update Date: 01/27/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2809 W WATERS AVE
TAMPA FL
33614-1852
US

IV. Provider business mailing address

2809 W WATERS AVE
TAMPA FL
33614-1852
US

V. Phone/Fax

Practice location:
  • Phone: 813-348-9088
  • Fax: 813-348-9310
Mailing address:
  • Phone: 813-348-9088
  • Fax: 813-348-9310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberME61567
License Number StateFL

VIII. Authorized Official

Name: THOMAS M. KERR
Title or Position: PARTNER
Credential: MD
Phone: 813-348-9088