MEDICARE: MICHAEL A THOMAS DO

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	207T00000X	Neurological Surgery Physician	OS12914	FL
2	208VP0014X	Interventional Pain Medicine Physician	OS12914	FL
3	207XS0117X	Orthopaedic Surgery of the Spine Physician	OS12914	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1588673461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL A THOMAS DO

Provider Business Mailing Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	#102
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	954-458-4488
Fax Number	:	954-458-2928

Provider Business Practice Location Address
First Line	:	3127 W HALLANDALE BEACH BLVD
Second Line	:	#102
City	:	HALLANDALE
State	:	FL
Zip	:	33009-5150
Country	:	US
Telephone Number	:	954-458-4488
Fax Number	:	954-458-2928

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	08/08/2016

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Directions to “ MICHAEL A THOMAS DO” Practice Location

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