Provider Demographics
NPI:1417016692
Name:THOMAS, JOSEPH F (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3165 MCCRORY PL STE 174
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32803-3727
Mailing Address - Country:US
Mailing Address - Phone:407-423-1234
Mailing Address - Fax:407-517-1040
Practice Address - Street 1:602 DELTONA BLVD
Practice Address - Street 2:
Practice Address - City:DELTONA
Practice Address - State:FL
Practice Address - Zip Code:32725
Practice Address - Country:US
Practice Address - Phone:386-860-1402
Practice Address - Fax:386-860-0528
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO 0001637213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
59-3148379OtherTAX ID
FL65037OtherBLUE CROSS
59-3148379OtherTAX ID
FLT63507Medicare UPIN
FL65037OtherBLUE CROSS