Provider Demographics
NPI:1033189188
Name:CSENCSITZ, THOMAS A (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:CSENCSITZ
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 1:22 W UNDERWOOD ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6100
Mailing Address - Country:US
Mailing Address - Phone:407-649-6878
Mailing Address - Fax:407-843-7381
Practice Address - Street 1:22 W UNDERWOOD ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-6100
Practice Address - Country:US
Practice Address - Phone:407-649-6878
Practice Address - Fax:407-843-7381
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2011-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28944207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL039703200Medicaid
FLD55021Medicare UPIN
FL47347Medicare ID - Type Unspecified
FL47347VMedicare PIN
FL47347Medicare PIN