Provider Demographics
NPI:1346608098
Name:TOMAS, ALEXANDER ALLAN (CRNA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:ALLAN
Last Name:TOMAS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 PEELER ST
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-2300
Mailing Address - Country:US
Mailing Address - Phone:269-345-8618
Mailing Address - Fax:269-345-1508
Practice Address - Street 1:11011 SHERIDAN ST STE 106
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33026-1501
Practice Address - Country:US
Practice Address - Phone:954-435-0101
Practice Address - Fax:954-435-0125
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9354178163W00000X
MI4704319374367500000X
IL209020649367500000X
FLAPRN9354178367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704319374OtherMI LICENSE
MIC96074202Medicare PIN