Provider Demographics
NPI:1003858135
Name:THOMAS, MARIA NICHOLE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:NICHOLE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6651 N MILITARY TRL
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33496-2402
Mailing Address - Country:US
Mailing Address - Phone:561-998-3747
Mailing Address - Fax:561-998-3797
Practice Address - Street 1:6651 N MILITARY TRL
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33496-2402
Practice Address - Country:US
Practice Address - Phone:561-998-3747
Practice Address - Fax:561-998-3797
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2017-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL3408092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBH641ZMedicare PIN