Basic Information
| Provider Information | |||||||||
| NPI: | 1871894386 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | THOMAS E. MATHIAS DOPA | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 6502 PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337813142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275415544 | ||||||||
| FaxNumber: | 7275468142 | ||||||||
| Practice Location | |||||||||
| Address1: | 6502 PARK BLVD | ||||||||
| Address2: | |||||||||
| City: | PINELLAS PARK | ||||||||
| State: | FL | ||||||||
| PostalCode: | 337813142 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7275415544 | ||||||||
| FaxNumber: | 7275468142 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/15/2010 | ||||||||
| LastUpdateDate: | 11/15/2010 | ||||||||
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| AuthorizedOfficialLastName: | MATHIAS | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
| AuthorizedOfficialMiddleName: | EUGENE | ||||||||
| AuthorizedOfficialTitleorPosition: | DOCTOR | ||||||||
| AuthorizedOfficialTelephone: | 7275415544 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | 0S0006027 | FL | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.