Provider Demographics
NPI:1609211879
Name:THOMAS, BRYAN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:ANTHONY
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2553 WINDGUARD CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-7351
Mailing Address - Country:US
Mailing Address - Phone:813-388-2948
Mailing Address - Fax:813-388-6827
Practice Address - Street 1:2553 WINDGUARD CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:813-388-2948
Practice Address - Fax:813-388-6827
Is Sole Proprietor?:No
Enumeration Date:2013-05-01
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME122075208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation