Provider Demographics
NPI:1366471823
Name:STENGEL, THOMAS J (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:STENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:603 7TH ST SOUTH
Mailing Address - Street 2:SUITE 540
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716
Mailing Address - Country:US
Mailing Address - Phone:727-828-8400
Mailing Address - Fax:727-828-8400
Practice Address - Street 1:603 7TH ST S
Practice Address - Street 2:#540
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4719
Practice Address - Country:US
Practice Address - Phone:727-553-7550
Practice Address - Fax:727-553-7549
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-30
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME81023207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0909520001OtherPALMETTO MEDICARE DME
FL259587700Medicaid
FL140007419OtherRAILROAD MEDICARE
FL35898OtherBCBS
FL0909520001OtherPALMETTO MEDICARE DME
FL35898ZMedicare ID - Type Unspecified