Provider Demographics
NPI:1730127572
Name:THOMAS, VICTOR B (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1033 DR MARTIN LUTHER KING JR ST N
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-1547
Mailing Address - Country:US
Mailing Address - Phone:727-456-4250
Mailing Address - Fax:727-346-1044
Practice Address - Street 1:790 CONCOURSE PKWY S
Practice Address - Street 2:SUITE 200
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6114
Practice Address - Country:US
Practice Address - Phone:407-767-6411
Practice Address - Fax:407-767-8160
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-09-02
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Provider Licenses
StateLicense IDTaxonomies
FLME87744207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71047OtherBLUE CROSS
FL7668429OtherAETNA
FL273562800Medicaid
FL71047YMedicare PIN
FL71047XMedicare PIN
FL71047OtherBLUE CROSS