Pistoria, Tamara Threlkeld

Pistoria, Tamara Threlkeld is an individual health care provider with primary practice located at 1033 N Parkway Frontage Rd , Lakeland FL 33803-0401. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Pistoria, Tamara Threlkeld can be contacted via phone (863) 647-8011.

Contact Information

Primary practice address
1033 N Parkway Frontage Rd Lakeland FL 33803-0401
Phone: (863) 647-8011
Fax: (863) 647-8029
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X OS0008614 Florida

Profile Details

NPI number 1932107158
LBN Legal business name Pistoria, Tamara Threlkeld
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2005
Last updated Jun 26th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932107158 NPPES
Florida MEDICAID 264246800

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