MEDICARE: DR. THOMAS FLEMING WALSH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	27695	OK
2	207RC0000X	Cardiovascular Disease Physician	27695	OK
3	207RM1200X	Magnetic Resonance Imaging (MRI) Internal Medicine Physician	27695	OK
4	207UN0901X	Nuclear Cardiology Physician	27695	OK
5	207UN0901X	Nuclear Cardiology Physician	ME117652	FL
6	207RC0000X	Cardiovascular Disease Physician	ME117652	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164431300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS FLEMING WALSH MD

Provider Business Mailing Address
First Line	:	1613 N MILLS AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803
Country	:	US
Telephone Number	:	407-894-4474
Fax Number	:	407-894-7136

Provider Business Practice Location Address
First Line	:	1613 N MILLS AVE
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32803
Country	:	US
Telephone Number	:	407-894-4474
Fax Number	:	407-894-7136

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	11/14/2018

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