MEDICARE: DR. MINI THOMAS M.D.

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	207R00000X	Internal Medicine Physician	ME93323	FL

General Provider Information

NPI Number	:	1184684656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MINI THOMAS M.D.

Provider Business Mailing Address
First Line	:	6530 SW 56TH ST
Second Line	:
City	:	DAVIE
State	:	FL
Zip	:	33314-7102
Country	:	US
Telephone Number	:	954-729-7976
Fax Number	:

Provider Business Practice Location Address
First Line	:	5440 N UNIVERSITY DR
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33351-5005
Country	:	US
Telephone Number	:	954-747-9897
Fax Number	:	954-747-9879

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

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	09/13/2013

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