Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0200X | Radiology | CH7778 | FL |
Y | 213ER0200X | Radiology | CH7778 | FL |
NPI | 1245321975 |
---|---|
Provider Name | Dr. Anthony Scott Thorpe |
First Address | St Petersburg, FL 33707 |
Second Address | St Petersburg, FL 33707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2006 |
Last Update Date | 18/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
55864 | BC/BS (01) | FL |
U77509 | (02) | FL |