Healthcare Provider Details

I. General information

NPI: 1205778941
Provider Name (Legal Business Name): PEYTON THAMES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1573 W FAIRBANKS AVE STE 300
WINTER PARK FL
32789-4679
US

IV. Provider business mailing address

2501 N ORANGE AVE STE 301
ORLANDO FL
32804-4642
US

V. Phone/Fax

Practice location:
  • Phone: 407-845-8362
  • Fax: 407-845-8363
Mailing address:
  • Phone: 407-303-2888
  • Fax: 407-303-2869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: