Provider Demographics
NPI:1790771970
Name:THOMAS M. KERR MD PA
Entity Type:Organization
Organization Name:THOMAS M. KERR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-348-9088
Mailing Address - Street 1:2809 W WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1852
Mailing Address - Country:US
Mailing Address - Phone:813-348-9088
Mailing Address - Fax:813-348-9310
Practice Address - Street 1:2809 W WATERS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-1852
Practice Address - Country:US
Practice Address - Phone:813-348-9088
Practice Address - Fax:813-348-9310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-23
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME615672086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL770001359Medicare PIN
FLDE2597Medicare PIN
FLK8224Medicare PIN