MEDICARE: THOMAS C. TOLLI MD PA

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	174400000X	Specialist	ME0069472	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	:	1235152208
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOMAS C. TOLLI MD PA

Provider Business Mailing Address
First Line	:	1001 37TH ST N
Second Line	:	SUITE C
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-6010
Country	:	US
Telephone Number	:	727-321-9644
Fax Number	:	727-327-0413

Provider Business Practice Location Address
First Line	:	1001 37TH ST N
Second Line	:	SUITE C
City	:	ST PETERSBURG
State	:	FL
Zip	:	33713-6010
Country	:	US
Telephone Number	:	727-321-9644
Fax Number	:	727-327-0413

Authorized Official
Title or Position	:	OWNER
Name	:	THOMAS C TOLLLI
Credential	:	MD PA
Telephone Number	:	727-321-9644

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	08/22/2020

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