Healthcare Provider Details

I. General information

NPI: 1376108134
Provider Name (Legal Business Name): ASHLEY J THOMAS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2019
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 OKEECHOBEE BLVD
WEST PALM BEACH FL
33401-6349
US

IV. Provider business mailing address

525 OKEECHOBEE BLVD
WEST PALM BEACH FL
33401-6349
US

V. Phone/Fax

Practice location:
  • Phone: 561-804-0200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS23077
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number81299
License Number StateWI
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number009666
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: