Provider Demographics
NPI:1386781409
Name:TOUMBIS, CONSTANTINE A (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:CONSTANTINE
Middle Name:A
Last Name:TOUMBIS
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6099 W GULF TO LAKE HWY
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-8721
Mailing Address - Country:US
Mailing Address - Phone:352-794-6868
Mailing Address - Fax:352-794-6869
Practice Address - Street 1:6099 W GULF TO LAKE HWY
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-8721
Practice Address - Country:US
Practice Address - Phone:352-794-6868
Practice Address - Fax:352-794-6869
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0080012207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269693200Medicaid
FL43266XMedicare ID - Type Unspecified
FL269693200Medicaid