Basic Information
Provider Information
NPI: 1952614281
EntityType: 2
ReplacementNPI:  
OrganizationName: STEVEN B TINSLEY MD PA
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 613 S MYRTLE AVE
Address2:  
City: CLEARWATER
State: FL
PostalCode: 33756
CountryCode: US
TelephoneNumber: 7274414526
FaxNumber: 7274613253
Practice Location
Address1: 613 S MYRTLE AVE
Address2:  
City: CLEARWATER
State: FL
PostalCode: 337565615
CountryCode: US
TelephoneNumber: 7274414526
FaxNumber: 7274613253
Other Information
ProviderEnumerationDate: 07/15/2010
LastUpdateDate: 01/23/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: TINSLEY
AuthorizedOfficialFirstName: STEVEN
AuthorizedOfficialMiddleName: B
AuthorizedOfficialTitleorPosition: OWNER/PRESIDENT
AuthorizedOfficialTelephone: 7274414526
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261QM1300XME 51360FLY Ambulatory Health Care FacilitiesClinic/CenterMulti-Specialty

No ID Information.


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