Provider Demographics
NPI:1922015031
Name:CROASMUN, THOMAS JAMES (ARNP)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:JAMES
Last Name:CROASMUN
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:4881 NW 8TH AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-4582
Mailing Address - Country:US
Mailing Address - Phone:352-373-6338
Mailing Address - Fax:352-373-6144
Practice Address - Street 1:4343 W NEWBERRY RD
Practice Address - Street 2:SUITE 10
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-2817
Practice Address - Country:US
Practice Address - Phone:352-224-2481
Practice Address - Fax:352-373-3140
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL2117926363LF0000X
FLARNP1550942363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL307771300Medicaid
FL307771300Medicaid