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General NPI Number Information
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NPI Number | 1205172723
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Entity Type | Individual
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Provider Name | LAZONIA THOMAS
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Gender | Female
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 04/19/2022
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Provider Practice Location Address
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Address Line | 13310 NW 151ST PL
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City | ALACHUA
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State | FL
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Zip | 32615-5890
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Country | US
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Telephone | 352-256-2709
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 966
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City | ALACHUA
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State | FL
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Zip | 32616-0966
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Country | US
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Telephone | 352-256-2709
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CNA188133
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 374700000X
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Taxonomy Name | Technician
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License Number | 22-0207
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License Number State | FL
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