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Individual

THERON EBEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 MEDICAL PARK DR, SUITE 190, TAMPA, FL 33613-4680
(813) 977-7794
(813) 355-5067
Mailing address
38135 MARKET SQUARE, ZEPHYRHILLS, FL 33542
(813) 528-4975

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME20283
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
260189300
FL
01
P00273074
RR MEDICARE
FL
Enumeration date
08/25/2006
Last updated
08/25/2021
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