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General NPI Number Information
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NPI Number | 1124818950
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Entity Type | Individual
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Provider Name | TREVOR THOMPSON PA-C
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Gender | Male
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Dates
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Enumeration Date | 05/06/2025
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Last Update Date | 06/14/2025
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Provider Practice Location Address
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Address Line | 2020 SEVEN SPRINGS BLVD
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City | NEW PORT RICHEY
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State | FL
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Zip | 34655-3933
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Country | US
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Telephone | 727-372-1311
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Fax |
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Provider Business Mailing Address
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Address Line | 4719 36TH AVE N
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City | ST PETERSBURG
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State | FL
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Zip | 33713-1016
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Country | US
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Telephone | 727-686-6564
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 9120238
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License Number State | FL
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