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NPI Code Detail

MEDICARE: DR. THOMAS R SYVERSON MD

MEDICARE:  DR. THOMAS R SYVERSON  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
1207QA0505XAdult Medicine PhysicianME54040FL
22084P2900XPain Medicine (Psychiatry & Neurology) PhysicianME54040FL

General Provider Information

NPI Number : 1750366290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS R SYVERSON MD
Provider Business Mailing Address
First Line : 14918 N FLORIDA AVE
Second Line :
City : TAMPA
State : FL
Zip : 33613-1632
Country : US
Telephone Number : 813-931-0000
Fax Number : 813-264-6868
Provider Business Practice Location Address
First Line : 7394 W GULF TO LAKE HWY
Second Line :
City : CRYSTAL RIVER
State : FL
Zip : 34429-7802
Country : US
Telephone Number : 904-475-2039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2005
Last Update Date : 11/30/2020

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Directions to “ DR. THOMAS R SYVERSON MD” Practice Location

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