Provider Demographics
NPI:1023999125
Name:IGNATIUS, TOM (MD)
Entity type:Individual
Prefix:DR
First Name:TOM
Middle Name:
Last Name:IGNATIUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6208 WATKINS AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-3844
Mailing Address - Country:US
Mailing Address - Phone:248-390-9609
Mailing Address - Fax:
Practice Address - Street 1:6208 WATKINS AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-3844
Practice Address - Country:US
Practice Address - Phone:248-390-9609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist