Provider Demographics
NPI:1497427512
Name:THOMAS, MEAGGAN (OTD)
Entity Type:Individual
Prefix:
First Name:MEAGGAN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OTD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E HENRY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604-6861
Mailing Address - Country:US
Mailing Address - Phone:843-697-2261
Mailing Address - Fax:
Practice Address - Street 1:1344 W FLETCHER AVE STE 104
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-3366
Practice Address - Country:US
Practice Address - Phone:813-961-1666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL22208225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist