Provider Demographics
NPI:1780416834
Name:HARVEY, THOMAS (CPT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HARVEY
Suffix:
Gender:M
Credentials:CPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9410 CERULEAN DR APT 303
Mailing Address - Street 2:
Mailing Address - City:RIVERVIEW
Mailing Address - State:FL
Mailing Address - Zip Code:33578-4783
Mailing Address - Country:US
Mailing Address - Phone:941-448-7121
Mailing Address - Fax:
Practice Address - Street 1:9410 CERULEAN DR APT 303
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-4783
Practice Address - Country:US
Practice Address - Phone:941-448-7121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-16
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLJ5X4D5E6246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy