Provider Demographics
NPI:1972828663
Name:THORNTON, DARREN THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:THOMAS
Last Name:THORNTON
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 1:7900 NW 27TH AVE STE E-12
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33147-4909
Mailing Address - Country:US
Mailing Address - Phone:786-318-2337
Mailing Address - Fax:786-228-4963
Practice Address - Street 1:7900 NW 27TH AVE STE E-12
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33147-4909
Practice Address - Country:US
Practice Address - Phone:786-318-2337
Practice Address - Fax:786-228-4963
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME117480207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME117480OtherMEDICAL LICENSE
FL103502600Medicaid
FLHO379ZMedicare PIN