Provider Demographics
NPI:1215034392
Name:DAVID P. MYERS, M.D., P.A.
Entity Type:Organization
Organization Name:DAVID P. MYERS, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF ATTORNEY
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:SWEENEY
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:813-931-5560
Mailing Address - Street 1:825 W LINEBAUGH AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33612-7855
Mailing Address - Country:US
Mailing Address - Phone:813-931-5560
Mailing Address - Fax:
Practice Address - Street 1:825 W LINEBAUGH AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-7855
Practice Address - Country:US
Practice Address - Phone:813-931-5560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34699261QP3300X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder