Provider Demographics
NPI:1114188547
Name:ELUVATHINGAL, THOMAS JOSE (MD,MB;BS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSE
Last Name:ELUVATHINGAL
Suffix:
Gender:M
Credentials:MD,MB;BS
Other - Prefix:DR
Other - First Name:THOMAS
Other - Middle Name:
Other - Last Name:ELUVATHINGAL JOSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3848 FAU BLVD STE 305
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-6437
Mailing Address - Country:US
Mailing Address - Phone:561-455-3627
Mailing Address - Fax:305-243-4613
Practice Address - Street 1:3848 FAU BLVD STE 305
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6437
Practice Address - Country:US
Practice Address - Phone:561-455-3627
Practice Address - Fax:305-243-4613
Is Sole Proprietor?:No
Enumeration Date:2008-06-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1521942085R0202X, 2085N0904X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program