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General NPI Number Information
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NPI Number | 1033658117
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Entity Type | Organization
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Legal Business Name | THOMAS MATHIAS D.O.
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Dates
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Enumeration Date | 02/22/2017
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Last Update Date | 02/22/2017
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Provider Practice Location Address
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Address Line | 6502 PARK BLVD N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3142
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Country | US
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Telephone | 727-541-5544
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Fax | 727-546-8142
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Provider Business Mailing Address
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Address Line | 6502 PARK BLVD N
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City | PINELLAS PARK
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State | FL
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Zip | 33781-3142
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Country | US
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Telephone | 727-541-5544
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Fax | 727-546-8142
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. STEVIE MATHIAS
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Credential |
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Telephone | 727-541-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS0006027
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License Number State | FL
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