MEDICARE: MR. BURTON W THOMAS III CAP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	ADC-010343-2015	FL

General Provider Information

NPI Number	:	1093212201
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BURTON W THOMAS III CAP

Provider Business Mailing Address
First Line	:	17 RANWOOD LN
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-6802
Country	:	US
Telephone Number	:	386-679-1388
Fax Number	:

Provider Business Practice Location Address
First Line	:	17 RANWOOD LN
Second Line	:
City	:	PALM COAST
State	:	FL
Zip	:	32164-6802
Country	:	US
Telephone Number	:	386-679-1388
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2018
Last Update Date	:	04/12/2018

Similar Medicare Providers

1265026298 — TAUREAN S. WILSON LMHC
Practice Location Address:

13 RANWOOD LN
PALM COAST, FL
32164-6802

Practice Phone: 386-385-8173
Practice Fax:

1154978559 — LIVING STONES HOSPICE CARE LLC
Practice Location Address:

75108 GERALD FORD DR STE 3
PALM DESERT, CA
92211-6802

Practice Phone: 760-898-4308
Practice Fax:

1508456682 — ASHANTE CHALCEDONY ANTENOR CCMA, CET
Practice Location Address:

1973 BRANDYWINE RD
WEST PALM BEACH, FL
33409-6802

Practice Phone: 954-289-7247
Practice Fax:

1710683610 — JOKEBEDE MEZIDOR
Practice Location Address:

1220 ALPHA ST
WEST PALM BEACH, FL
33401-6802

Practice Phone: 561-603-0295
Practice Fax:

1174403034 — THOMAS SAINTILUS
Practice Location Address:

6802 ALISO AVE
WEST PALM BEACH, FL
33413-1036

Practice Phone: 561-729-1683
Practice Fax:

1619997384 — MR. JAMES S BLASKO M.D.
Practice Location Address:

50 CYPRESS POINT PKWY STE C1C2
PALM COAST, FL
32164-2500

Practice Phone: 386-447-6156
Practice Fax: 904-819-4133

Directions to “ MR. BURTON W THOMAS III CAP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.