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NPI Code Detail

MEDICARE: JERINA THOMAS

MEDICARE:   JERINA  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
1183500000XPharmacistPS53999FL

General Provider Information

NPI Number : 1588020861
Entity Type Code : Individual
Provider Name (Legal Business Name) : JERINA THOMAS
Provider Business Mailing Address
First Line : 2873 S ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-5403
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2873 S ORANGE AVE
Second Line :
City : ORLANDO
State : FL
Zip : 32806-5403
Country : US
Telephone Number : 407-872-0395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2016
Last Update Date : 01/03/2016

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Directions to “ JERINA THOMAS ” Practice Location

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