Organization
GERIATRIC MEDICAL SPECIALISTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM HAITHCOAT (PRESIDENT)
(317) 370-2013
Entity
Organization
Contact information
Practice address
200 CENTRAL AVE FL 4, ST PETERSBURG, FL 33701-3566
(317) 370-2013
Mailing address
200 CENTRAL AVE FL 4, ST PETERSBURG, FL 33701-3566
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Enumeration date
07/28/2023
Last updated
07/28/2023
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