Individual
MR. THOMAS SCOTT GENNARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C.
Contact information
Practice address
270 S MOON AVE, BRANDON, FL 33511-5711
(813) 571-9988
(813) 571-9922
Mailing address
6006 49TH ST N, STE 310, ST PETERSBURG, FL 33709-2148
(727) 490-5040
(727) 490-5045
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA1808
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009471200
—
FL
01
—
P01320498
RR MEDICARE
FL
Enumeration date
10/13/2006
Last updated
01/27/2022
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