Individual
CODY E THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701-4629
(727) 898-2663
(727) 568-6836
Mailing address
625 6TH AVE S STE 450, ST PETERSBURG, FL 33701-4629
(727) 898-2663
(727) 568-6836
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA9103535
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9103535
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
292378500
—
FL
Enumeration date
12/16/2005
Last updated
05/22/2025
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