Provider Demographics
NPI:1871894386
Name:THOMAS E. MATHIAS DOPA
Entity type:Organization
Organization Name:THOMAS E. MATHIAS DOPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MATHIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-541-5544
Mailing Address - Street 1:6502 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3142
Mailing Address - Country:US
Mailing Address - Phone:727-541-5544
Mailing Address - Fax:727-546-8142
Practice Address - Street 1:6502 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3142
Practice Address - Country:US
Practice Address - Phone:727-541-5544
Practice Address - Fax:727-546-8142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0S0006027332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies