Provider Demographics
NPI:1639112725
Name:THOMAS, PATRICIA (PA)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 N. MILITARY TRAIL
Mailing Address - Street 2:MEDICINE (111)
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33410
Mailing Address - Country:US
Mailing Address - Phone:561-422-6650
Mailing Address - Fax:561-422-8708
Practice Address - Street 1:7305 N. MILITARY TRAIL
Practice Address - Street 2:MEDICINE (111)
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410
Practice Address - Country:US
Practice Address - Phone:561-422-6650
Practice Address - Fax:561-422-8708
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA3746363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA3746OtherLICENSE