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General NPI Number Information
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NPI Number | 1043903842
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Entity Type | Organization
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Legal Business Name | JAIME THONY PA
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 07/01/2023
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Provider Practice Location Address
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Address Line | 1450 TUSKAWILLA RD STE 116
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5204
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Country | US
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Telephone | 850-459-5678
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Fax |
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Provider Business Mailing Address
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Address Line | 2770 ANDES WAY
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City | SAINT CLOUD
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State | FL
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Zip | 34769-5233
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Country | US
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Telephone | 850-459-5678
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. JAIME THONY
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Credential | DDS
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Telephone | 850-459-5678
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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