Provider Demographics
NPI:1598902280
Name:THOMAS PAULANTONIO D.C., P.A.
Entity Type:Organization
Organization Name:THOMAS PAULANTONIO D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:PAULANTONIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:727-521-4244
Mailing Address - Street 1:5001 FOURTH STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:ST. PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703
Mailing Address - Country:US
Mailing Address - Phone:727-521-4244
Mailing Address - Fax:727-526-1051
Practice Address - Street 1:5001 FOURTH STREET NORTH
Practice Address - Street 2:
Practice Address - City:ST. PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703
Practice Address - Country:US
Practice Address - Phone:727-521-4244
Practice Address - Fax:727-526-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3903111N00000X
111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88908Medicare UPIN