Individual
DR. THOMAS NIENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5880 49TH ST N STE N-104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895
Mailing address
5880 49TH ST N STE N-104, ST PETERSBURG, FL 33709-2150
(727) 528-6100
(727) 528-7895
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
OS12013
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008659300
—
FL
01
—
HI139Y
MEDICARE PTAN
FL
Enumeration date
09/30/2008
Last updated
03/17/2018
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