Provider Demographics
NPI:1700031671
Name:INFECTIOUS DISEASE CONSULTANTS SANIL THOMAS MD LLC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE CONSULTANTS SANIL THOMAS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D.
Authorized Official - Prefix:
Authorized Official - First Name:SANIL
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-375-0008
Mailing Address - Street 1:9116 SW 51ST RD
Mailing Address - Street 2:SUITE A-103
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-8167
Mailing Address - Country:US
Mailing Address - Phone:352-375-0008
Mailing Address - Fax:352-375-0810
Practice Address - Street 1:9116 SW 51ST RD
Practice Address - Street 2:SUITE A-103
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-8167
Practice Address - Country:US
Practice Address - Phone:352-375-0008
Practice Address - Fax:352-375-0810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 100089207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000796800Medicaid
FLBP830ZMedicare PIN