Healthcare Provider Details

I. General information

NPI: 1730667999
Provider Name (Legal Business Name): JOSEPH F THOMAS DPM PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2018
Last Update Date: 07/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 MONASTERY RD STE B
ORANGE CITY FL
32763-6222
US

IV. Provider business mailing address

602 DELTONA BLVD
DELTONA FL
32725-8078
US

V. Phone/Fax

Practice location:
  • Phone: 386-456-1500
  • Fax:
Mailing address:
  • Phone: 386-860-1402
  • Fax: 386-860-0528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO1637
License Number StateFL

VIII. Authorized Official

Name: JOSEPH F THOMAS
Title or Position: DPM
Credential: DPM
Phone: 386-860-1402