Provider Demographics
NPI:1841717675
Name:THOMAS, ROBERT (DRPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DRPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5101 ISABELLE DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32305-5523
Mailing Address - Country:US
Mailing Address - Phone:904-600-6313
Mailing Address - Fax:
Practice Address - Street 1:2013 MICCOSUKEE RD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5307
Practice Address - Country:US
Practice Address - Phone:850-391-6060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician