Provider Demographics
NPI:1497317481
Name:THOMAS-BURTON, NADINE
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:THOMAS-BURTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:919 NE 13TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-2012
Mailing Address - Country:US
Mailing Address - Phone:954-763-2030
Mailing Address - Fax:954-467-5844
Practice Address - Street 1:919 NE 13TH ST
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-2012
Practice Address - Country:US
Practice Address - Phone:954-763-2030
Practice Address - Fax:954-763-2030
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker