Provider Demographics
NPI:1982647210
Name:THOMAS, DANIEL (RD/LD,N)
Entity Type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:RD/LD,N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3850 FALCON RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33331-5015
Mailing Address - Country:US
Mailing Address - Phone:954-389-1758
Mailing Address - Fax:
Practice Address - Street 1:3850 FALCON RIDGE CIR
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33331-5015
Practice Address - Country:US
Practice Address - Phone:954-389-1758
Practice Address - Fax:
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
FLND4188133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal