Provider Demographics
NPI:1811952971
Name:HEMINGWAY, THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:HEMINGWAY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 S PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32118-4422
Mailing Address - Country:US
Mailing Address - Phone:386-310-2160
Mailing Address - Fax:386-310-2106
Practice Address - Street 1:222 S PENINSULA DR
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32118-4422
Practice Address - Country:US
Practice Address - Phone:386-310-2160
Practice Address - Fax:386-310-2106
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87616207P00000X
HIMD - 13711207P00000X
FLME153423207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL117219200Medicaid
CA00A876160Medicaid
CA00A876160Medicare ID - Type UnspecifiedMEDICARE