Provider Demographics
NPI:1144204124
Name:PEARSON, THOMAS O (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:O
Last Name:PEARSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35111 US HIGHWAY 19 N
Mailing Address - Street 2:SUITE 207
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34684-1935
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35111 US HIGHWAY 19 N
Practice Address - Street 2:SUITE 207
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34684-1935
Practice Address - Country:US
Practice Address - Phone:727-599-4705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1112672084N0400X, 2084S0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL004456400Medicaid
FL004456400Medicaid
FLFT204ZMedicare PIN
FL7649027OtherCIGNA
FL004456400Medicaid
PA130013314OtherRAILROAD MEDICARE
FLP01049622OtherRAILROAD MEDICARE
FL14JH0OtherBCBS
PA0012037320004Medicaid
FLFT204ZMedicare PIN