Provider Demographics
NPI:1740201839
Name:OHMS, DEANNA L (DO)
Entity Type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:L
Last Name:OHMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17653 N. DALE MABRY HWY
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33548
Mailing Address - Country:US
Mailing Address - Phone:813-908-0483
Mailing Address - Fax:813-908-0495
Practice Address - Street 1:17653 N. DALE MABRY HWY
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33548
Practice Address - Country:US
Practice Address - Phone:813-908-0483
Practice Address - Fax:813-908-0495
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS9685207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278762800Medicaid
FLAD957ZMedicare PIN
FLAD957WMedicare PIN
FLAD957XMedicare PIN