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General NPI Number Information
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NPI Number | 1174577159
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Entity Type | Individual
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Provider Name | JOHN BROOKE TOURTELOT M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2006
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Last Update Date | 01/24/2013
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Provider Practice Location Address
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Address Line | 455 PINELLAS ST
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City | CLEARWATER
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State | FL
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Zip | 33756-3354
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Country | US
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Telephone | 727-461-8300
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Fax | 727-298-6924
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Provider Business Mailing Address
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Address Line | PO BOX 1698
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City | CLEARWATER
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State | FL
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Zip | 33757-1698
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Country | US
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Telephone | 727-532-0002
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Fax | 727-532-1318
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME88865
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License Number State | FL
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