MEDICARE: JISHA 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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	9307478	FL

General Provider Information

NPI Number	:	1487589388
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JISHA THOMAS

Provider Business Mailing Address
First Line	:	8837 NW 57TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2874
Country	:	US
Telephone Number	:	954-681-3875
Fax Number	:

Provider Business Practice Location Address
First Line	:	8837 NW 57TH CT
Second Line	:
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33067-2874
Country	:	US
Telephone Number	:	954-681-3875
Fax Number	:

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

Provider Enumeration Date	:	06/15/2026
Last Update Date	:	06/15/2026

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Directions to “ JISHA THOMAS ” Practice Location

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