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NPI Code Detail

MEDICARE: ZACHARY THOMAS PA-C

MEDICARE: ZACHARY THOMAS PA-C
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
12255A2300XAthletic TrainerA00512MD
2363A00000XPhysician AssistantPA9117178FL
3363A00000XPhysician AssistantC0008128MD
4363A00000XPhysician Assistant9636GA
5363AS0400XSurgical Physician AssistantPA9117178FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477994325
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZACHARY THOMAS PA-C
Provider Business Mailing Address
First Line : PO BOX 936535
Second Line :
City : ATLANTA
State : GA
Zip : 31193-6535
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1995 E OAKLAND PARK BLVD STE 310
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33306-1138
Country : US
Telephone Number : 954-791-6146
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2013
Last Update Date : 03/08/2023

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1417321894 — MR. TREVOR ALLEN KOLSKI PA-C
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Practice Fax:

Directions to “ ZACHARY THOMAS PA-C” Practice Location

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