Healthcare Provider Details

I. General information

NPI: 1376502161
Provider Name (Legal Business Name): THOMAS P ENYART DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2006
Last Update Date: 05/21/2020
Certification Date: 05/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1578 W ORANGE BLOSSOM TRL BLDG 1560
APOPKA FL
32712-2639
US

IV. Provider business mailing address

1578 W ORANGE BLOSSOM TRL BLDG 1560
APOPKA FL
32712-2639
US

V. Phone/Fax

Practice location:
  • Phone: 407-635-3240
  • Fax: 407-636-7847
Mailing address:
  • Phone: 407-635-3240
  • Fax: 407-636-7847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberOS8940
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: