MEDICARE: THOMAS FOSTER

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	152W00000X	Optometrist	OPC819	FL

General Provider Information

NPI Number	:	1477795284
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS FOSTER

Provider Business Mailing Address
First Line	:	3790 PINEBROOK CIRCLE
Second Line	:	UNIT 502
City	:	BRADENTON
State	:	FL
Zip	:	34209-8052
Country	:	US
Telephone Number	:	770-543-8667
Fax Number	:

Provider Business Practice Location Address
First Line	:	803 CORTEZ RD W
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34207-1433
Country	:	US
Telephone Number	:	941-753-2323
Fax Number	:

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

Provider Enumeration Date	:	03/26/2009
Last Update Date	:	06/08/2016

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Directions to “ THOMAS FOSTER ” Practice Location

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