Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS 8476 | FL |
NPI | 1285844902 |
---|---|
Provider Name | Dr. Thomas James Fotopoulos |
First Address | Sarasota, FL 34243-3066 |
Second Address | Sarasota, FL 34243-3066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2007 |
Last Update Date | 08/07/2007 |