Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | ME99925 | FL |
NPI | 1013163625 |
---|---|
Provider Name | Tobias Quinton Gibson |
First Address | Tampa, FL 33655-2106 |
Second Address | Bradenton, FL 34209-4616 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2008 |
Last Update Date | 14/08/2008 |