MEDICARE: DR. THOMAS W NOONE MD PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	ME0070664	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31440	OTHER	FL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356335483
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS W NOONE MD PA

Provider Business Mailing Address
First Line	:	100 MADRID BLVD
Second Line	:	113
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-7968
Country	:	US
Telephone Number	:	941-205-5205
Fax Number	:	941-205-5210

Provider Business Practice Location Address
First Line	:	100 MADRID BLVD
Second Line	:	113
City	:	PUNTA GORDA
State	:	FL
Zip	:	33950-7968
Country	:	US
Telephone Number	:	941-205-5205
Fax Number	:	941-205-5210

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2005
Last Update Date	:	05/30/2008

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