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General NPI Number Information
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NPI Number | 1932163896
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Entity Type | Individual
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Provider Name | THOMAS ANGELO PANE M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 875 MILITARY TRL SUITE #210
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City | JUPITER
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State | FL
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Zip | 33458-5700
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Country | US
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Telephone | 561-747-8100
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Fax | 561-746-0495
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Provider Business Mailing Address
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Address Line | 224 LONE PINE DR
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2467
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Country | US
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Telephone | 561-775-7819
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Fax | 561-775-7839
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME 94792
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License Number State | FL
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