Provider Demographics
NPI:1326148198
Name:TOMITA, B. AURORA F (MD)
Entity Type:Individual
Prefix:DR
First Name:B. AURORA
Middle Name:F
Last Name:TOMITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:B. AURORA
Other - Middle Name:G
Other - Last Name:FERNANDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2000 HARTMAN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-4412
Mailing Address - Country:US
Mailing Address - Phone:772-465-1170
Mailing Address - Fax:
Practice Address - Street 1:2000 HARTMAN RD STE 1
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-4412
Practice Address - Country:US
Practice Address - Phone:808-432-0000
Practice Address - Fax:772-465-1170
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME133083207RN0300X
HIMD-8216207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL024547500Medicaid
HI006914Medicaid
HI0000211490OtherHMSA BILLING NUMBER
HIG08165Medicare UPIN