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NPI Code Detail

MEDICARE: BRUCE THOMAS MD

MEDICARE: BRUCE THOMAS MD
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
1207Q00000XFamily Medicine PhysicianME0085069FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1ME0085069OTHERFLMEDICAL LICENSE
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
362987OTHERFLBC
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336173863
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRUCE THOMAS MD
Provider Business Mailing Address
First Line : 23343 NW COUNTY ROAD 236
Second Line :
City : TRENTON
State : FL
Zip : 32643-9669
Country : US
Telephone Number : 386-454-0698
Fax Number : 386-454-0690
Provider Business Practice Location Address
First Line : 1830 N MAIN ST
Second Line :
City : BELL
State : FL
Zip : 32619-4713
Country : US
Telephone Number : 352-463-1100
Fax Number : 352-463-4507
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 03/03/2020

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Directions to “ BRUCE THOMAS MD” Practice Location

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