Thiel, Derrick Daniel

Thiel, Derrick Daniel is an sole proprietor health care provider with primary practice located at 214 Morrison Rd Suite 104, Brandon FL 33511. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Thiel, Derrick Daniel can be contacted via phone (813) 681-6474.

Contact Information

Primary practice address
214 Morrison Rd Suite 104 Brandon FL 33511
Phone: (813) 681-6474
Fax: (813) 681-9092
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X UO1132 Florida
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X OS9317 Florida

Profile Details

NPI number 1164510566
LBN Legal business name Thiel, Derrick Daniel
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2006
Last updated Oct 12th, 2012 - about 13 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 1164510566 NPPES
Florida MEDICAID 1937700
Florida MEDICAID 001937700
Florida Other 145RC

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