Provider Demographics
NPI:1043236565
Name:THOMAS E. CARSON, M.D., P.A.
Entity Type:Organization
Organization Name:THOMAS E. CARSON, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-938-1908
Mailing Address - Street 1:1259 S PINELLAS AVE
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-3719
Mailing Address - Country:US
Mailing Address - Phone:727-938-1908
Mailing Address - Fax:727-938-8693
Practice Address - Street 1:1259 S PINELLAS AVE
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-3719
Practice Address - Country:US
Practice Address - Phone:727-938-1908
Practice Address - Fax:727-938-8693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME36578207Q00000X
FLOS9655207Q00000X
FLME108731207Q00000X
FLME110547207Q00000X
FLPA9105368363A00000X
FLARNP1658442363L00000X
FLARNP3391502363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004037600Medicaid
FL1043236565OtherNPI GROUP NUMBER
FL1962733261OtherNPI NUMBER
FL1316337769OtherNPI NUMBER
FL1427058791OtherNPI NUMBER
FL1376544049OtherNPI NUMBER
FL1417114737OtherNPI NUMBER
FL002575201Medicaid
FL039716400Medicaid
FL1053624221OtherNPI
FL274337000Medicaid
FL1154313997OtherNPI NUMBER
FL002575200Medicaid
FL004107200Medicaid
FL005549700Medicaid
FL1487926861OtherNPI GROUP NUMBER TRINITY
FL304782201Medicaid
FL039716400Medicaid
FL1427058791OtherNPI NUMBER
FL1376544049OtherNPI NUMBER
FLD65322Medicare UPIN
FL004107200Medicaid
FL1154313997OtherNPI NUMBER
FL1962733261OtherNPI NUMBER
FL002575200Medicaid
FL274337000Medicaid
FLCU545Medicare PIN
FLIE439ZMedicare PIN
FLE8627YMedicare PIN