Provider Demographics
NPI:1619276102
Name:TZIKAS, THOMAS LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEWIS
Last Name:TZIKAS
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 1:526 SE 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5213
Mailing Address - Country:US
Mailing Address - Phone:561-330-9500
Mailing Address - Fax:561-330-8629
Practice Address - Street 1:526 SE 5TH AVE
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-5213
Practice Address - Country:US
Practice Address - Phone:561-330-9500
Practice Address - Fax:561-330-8629
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-23
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME70709207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG36467Medicare UPIN