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1932167814

NPI Code Detail

MEDICARE: KATHIRAVELU THABOLINGAM MD

MEDICARE: KATHIRAVELU THABOLINGAM 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	2084P0800X	Psychiatry Physician	ME133935	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	38-2368583	OTHER		TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932167814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHIRAVELU THABOLINGAM MD

Provider Business Mailing Address
First Line	:	700 8TH AVE W STE 101
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-4737
Country	:	US
Telephone Number	:	941-776-4000
Fax Number	:	941-845-4963

Provider Business Practice Location Address
First Line	:	725 N 12TH AVE BLDG B
Second Line	:
City	:	ARCADIA
State	:	FL
Zip	:	34266-8752
Country	:	US
Telephone Number	:	863-494-1242
Fax Number	:	863-491-0466

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

Provider Enumeration Date	:	05/02/2006
Last Update Date	:	03/07/2018

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Directions to “ KATHIRAVELU THABOLINGAM MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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