Provider Demographics
NPI:1336161892
Name:THOMAS, ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 860554
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-0554
Mailing Address - Country:US
Mailing Address - Phone:904-346-3606
Mailing Address - Fax:904-346-0113
Practice Address - Street 1:5731 BEE RIDGE RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34233-5056
Practice Address - Country:US
Practice Address - Phone:941-342-1100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0008592207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1779261Medicaid
FL13731OtherBCBS
MS07351012Medicaid
FL272690400Medicaid
FL930122649OtherRAILROAD MEDICARE
FL930122649OtherRAILROAD MEDICARE
MS07351012Medicaid