Provider Demographics
NPI:1033420898
Name:KUERBITZ, THOMAS GREGORY II (PA-C)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GREGORY
Last Name:KUERBITZ
Suffix:II
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-3409
Mailing Address - Country:US
Mailing Address - Phone:850-767-3350
Mailing Address - Fax:850-767-3353
Practice Address - Street 1:14027 5TH ST
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4302
Practice Address - Country:US
Practice Address - Phone:352-518-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-27
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2725363AM0700X
IL085003761363AM0700X
FLPA9110093363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical