Provider Demographics
NPI:1912098054
Name:THOMAS, SARAH T (RPT)
Entity Type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:T
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2570 W INTERNATIONAL SPEEDWAY BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-8145
Mailing Address - Country:US
Mailing Address - Phone:386-257-2672
Mailing Address - Fax:386-252-1005
Practice Address - Street 1:2570 W INTERNATIONAL SPEEDWAY BLVD STE 110
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-8145
Practice Address - Country:US
Practice Address - Phone:386-257-2672
Practice Address - Fax:386-252-1005
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT2831225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLY2300ZMedicare ID - Type Unspecified