Provider Demographics
NPI:1366688699
Name:THOMAS, JESSICA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:MARIE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:943 S BENEVA RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-2476
Mailing Address - Country:US
Mailing Address - Phone:941-953-5213
Mailing Address - Fax:941-953-3087
Practice Address - Street 1:943 S BENEVA RD
Practice Address - Street 2:SUITE 204
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34232-2476
Practice Address - Country:US
Practice Address - Phone:941-953-5213
Practice Address - Fax:941-953-3087
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 122281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine