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Individual

PHOUTTHASONE THIRAKUL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
11025 N 46TH ST, TAMPA, FL 33617-2000
(813) 914-4500
Mailing address
11025 N 46TH ST, TAMPA, FL 33617-2000
(813) 914-4500

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A125018
CA

Other

Enumeration date
04/01/2014
Last updated
06/16/2015
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