MEDICARE: DR. THERESA X DAM LOHMILLER M.D.

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	207Q00000X	Family Medicine Physician	ME110405	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	:	1598998965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THERESA X DAM LOHMILLER M.D.

Provider Business Mailing Address
First Line	:	4541 S DALE MABRY HWY STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1407
Country	:	US
Telephone Number	:	813-533-7030
Fax Number	:	813-605-6059

Provider Business Practice Location Address
First Line	:	4541 S DALE MABRY HWY STE 100
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-1407
Country	:	US
Telephone Number	:	813-533-7030
Fax Number	:	813-605-6059

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

Provider Enumeration Date	:	09/01/2009
Last Update Date	:	06/14/2024

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