Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | ME61234 | FL |
NPI | 1013916683 |
---|---|
Provider Name | Dr. Thomas F Conroy |
First Address | Tarpon Springs, FL 34688-7335 |
Second Address | South Pasadena, FL 33707-3717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2005 |
Last Update Date | 04/11/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
253526200 | (05) | FL |
593670221 | TAX ID (01) | FL |