Provider Demographics
NPI:1053387787
Name:TIRONE, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:TIRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1106 DRUID RD SOUTH
Mailing Address - Street 2:STE 301
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3841
Mailing Address - Country:US
Mailing Address - Phone:727-446-5681
Mailing Address - Fax:727-461-6258
Practice Address - Street 1:1106 DRUID RD SOUTH
Practice Address - Street 2:STE 301
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3841
Practice Address - Country:US
Practice Address - Phone:727-446-5681
Practice Address - Fax:727-461-6258
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101-234889208600000X
FLME97995208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010088097Medicaid
FL278124700Medicaid
FLAF210ZOtherPTAN
FLAF210ZMedicare PIN
FLAF210ZOtherPTAN
H02525Medicare UPIN
005384C25Medicare ID - Type Unspecified
VA010088097Medicaid
FLH02525Medicare UPIN