Provider Demographics
NPI:1083726889
Name:LAMA, MICHAEL THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:THOMAS
Last Name:LAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4135 HOLLAND DR
Mailing Address - Street 2:
Mailing Address - City:ST PETE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33706-2642
Mailing Address - Country:US
Mailing Address - Phone:727-938-8806
Mailing Address - Fax:727-934-6370
Practice Address - Street 1:2680 HUNT RD
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-7335
Practice Address - Country:US
Practice Address - Phone:727-938-8806
Practice Address - Fax:727-934-6370
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2015-08-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME118796207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL471819039OtherTAX ID