Provider Demographics
NPI:1184676801
Name:CHAMBERS, THOMAS EUGENE JR (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EUGENE
Last Name:CHAMBERS
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S GOLDENROD RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32822-8113
Mailing Address - Country:US
Mailing Address - Phone:407-275-1160
Mailing Address - Fax:407-275-3991
Practice Address - Street 1:900 S GOLDENROD RD
Practice Address - Street 2:SUITE B
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32822-8113
Practice Address - Country:US
Practice Address - Phone:407-275-1160
Practice Address - Fax:407-275-3991
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS4276207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL82387OtherBCBS
FL378111900Medicaid
080024504OtherRAILROAD MEDICARE
FL378111900Medicaid
D86387Medicare UPIN