Individual
DR. NEIL ALLEN THIERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12512 BRUCE B DOWNS BLVD, TAMPA, FL 33612-9209
(813) 977-8700
(813) 971-2029
Mailing address
6913 COHASSET CIR, RIVERVIEW, FL 33578-8314
(813) 731-4066
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
91604
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
277414300
—
FL
01
—
53191
BLUE CROSS/BLUE SHIELD
FL
Enumeration date
08/11/2006
Last updated
09/04/2015
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