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NPI Code Detail

MEDICARE: THOMAS THOMMI

MEDICARE: THOMAS THOMMI
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
1207R00000XInternal Medicine PhysicianME45964FL

General Provider Information

NPI Number : 1750552212
Entity Type Code : Organization
Provider Name (Legal Business Name) : THOMAS THOMMI
Provider Business Mailing Address
First Line : PO BOX 550698
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32255-0698
Country : US
Telephone Number : 904-724-9202
Fax Number : 904-724-3797
Provider Business Practice Location Address
First Line : 6300 BEACH BLVD
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32216-2708
Country : US
Telephone Number : 904-724-9202
Fax Number : 904-724-3797
Authorized Official
Title or Position : PRESIDENT
Name : THOMAS THOMMI
Credential : MD
Telephone Number : 904-642-6999
Provider Enumeration Date : 03/12/2008
Last Update Date : 08/03/2009

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