MEDICARE: THOMAS THOMMI 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
1	207R00000X	Internal Medicine Physician	ME45964	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME45964	OTHER	FL	FL STATE LICENSE #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508949611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS THOMMI MD

Provider Business Mailing Address
First Line	:	PO BOX 550698
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32255-0698
Country	:	US
Telephone Number	:	904-733-6677
Fax Number	:	904-733-0081

Provider Business Practice Location Address
First Line	:	2061 HYDE PARK RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32210-3815
Country	:	US
Telephone Number	:	904-786-7331
Fax Number	:	904-786-4034

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

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	04/02/2019

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