MEDICARE: CAROL THOMAS

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	163WH0200X	Home Health Registered Nurse	RN9170679	FL

General Provider Information

NPI Number	:	1164175246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL THOMAS

Provider Business Mailing Address
First Line	:	7800 PANAMA ST
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33023-3566
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3625 NW 187TH ST
Second Line	:
City	:	MIAMI GARDENS
State	:	FL
Zip	:	33056-2947
Country	:	US
Telephone Number	:	305-627-8457
Fax Number	:

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

Provider Enumeration Date	:	01/30/2022
Last Update Date	:	01/30/2022

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Directions to “ CAROL THOMAS ” Practice Location

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