Provider Demographics
NPI:1376502161
Name:ENYART, THOMAS P (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:P
Last Name:ENYART
Suffix:
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 1:1578 W ORANGE BLOSSOM TRL BLDG 1560
Mailing Address - Street 2:
Mailing Address - City:APOPKA
Mailing Address - State:FL
Mailing Address - Zip Code:32712-2639
Mailing Address - Country:US
Mailing Address - Phone:407-635-3240
Mailing Address - Fax:407-636-7847
Practice Address - Street 1:1578 W ORANGE BLOSSOM TRL BLDG 1560
Practice Address - Street 2:
Practice Address - City:APOPKA
Practice Address - State:FL
Practice Address - Zip Code:32712-2639
Practice Address - Country:US
Practice Address - Phone:407-635-3240
Practice Address - Fax:407-636-7847
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8940207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL269726200Medicaid
FLU3230ZMedicare ID - Type Unspecified
I16066Medicare UPIN