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General NPI Number Information
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NPI Number | 1992370209
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Entity Type | Individual
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Provider Name | TIGHE PAUL SHOMER MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/20/2021
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Provider Practice Location Address
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Address Line | 7550 SW 128TH ST
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City | PINECREST
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State | FL
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Zip | 33156-6102
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Country | US
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Telephone | 305-252-3919
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Fax | 305-252-6100
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Provider Business Mailing Address
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Address Line | 7550 SW 128TH ST
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City | PINECREST
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State | FL
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Zip | 33156-6102
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Country | US
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Telephone | 305-252-3919
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Fax | 305-252-6100
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME33050
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License Number State | FL
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