Provider Demographics
NPI:1730484957
Name:THOMAS F. YOHO DDS PA
Entity Type:Organization
Organization Name:THOMAS F. YOHO DDS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:F
Authorized Official - Last Name:YOHO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-623-7014
Mailing Address - Street 1:5811 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-2813
Mailing Address - Country:US
Mailing Address - Phone:813-623-1014
Mailing Address - Fax:813-620-3863
Practice Address - Street 1:5811 E BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-2813
Practice Address - Country:US
Practice Address - Phone:813-623-1014
Practice Address - Fax:813-620-3863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN64791223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL076300400OtherMEDICAID GROUP
FL1346368594OtherNPI
FL076303900Medicaid