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General NPI Number Information
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NPI Number | 1740339464
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Entity Type | Individual
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Provider Name | THOMAS A NETTER MD
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Gender | Male
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 09/11/2012
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Provider Practice Location Address
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Address Line | 12196 COUNTY ROAD 512
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City | FELLSMERE
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State | FL
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Zip | 32948-5463
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Country | US
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Telephone | 772-257-8224
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Fax | 772-571-8846
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Provider Business Mailing Address
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Address Line | 230 5TH AVE
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City | INDIALANTIC
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State | FL
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Zip | 32903-3176
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Country | US
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Telephone | 321-956-7530
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME33902
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License Number State | FL
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