Provider Demographics
NPI:1164431300
Name:WALSH, THOMAS FLEMING (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FLEMING
Last Name:WALSH
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 1:1613 N MILLS AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803
Mailing Address - Country:US
Mailing Address - Phone:407-894-4474
Mailing Address - Fax:407-894-7136
Practice Address - Street 1:1613 N MILLS AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803
Practice Address - Country:US
Practice Address - Phone:407-894-4474
Practice Address - Fax:407-894-7136
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK27695207R00000X, 207RC0000X, 207RM1200X, 207UN0901X
FLME117652207UN0901X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RM1200XAllopathic & Osteopathic PhysiciansInternal MedicineMagnetic Resonance Imaging (MRI)
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology