Individual
KATHIRAVELU THABOLINGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
725 N 12TH AVE BLDG B, ARCADIA, FL 34266-8752
(863) 494-1242
(863) 491-0466
Mailing address
700 8TH AVE W STE 101, PALMETTO, FL 34221-4737
(941) 776-4000
(941) 845-4963
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME133935
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1397556-10
—
MI
01
—
38-2368583
TAX ID
—
Enumeration date
05/02/2006
Last updated
03/07/2018
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