MEDICARE: ROGER P. THOMAS 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	208100000X	Physical Medicine & Rehabilitation Physician	ME117289	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

General Provider Information

NPI Number	:	1760474712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROGER P. THOMAS MD

Provider Business Mailing Address
First Line	:	PO BOX 3123
Second Line	:
City	:	ST AUGUSTINE
State	:	FL
Zip	:	32085-3123
Country	:	US
Telephone Number	:	904-824-4990
Fax Number	:	904-824-2226

Provider Business Practice Location Address
First Line	:	307 E NEW HAVEN AVE
Second Line	:
City	:	MELBOURNE
State	:	FL
Zip	:	32901-4576
Country	:	US
Telephone Number	:	321-729-8223
Fax Number	:	321-729-6252

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

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	12/13/2013

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Directions to “ ROGER P. THOMAS MD” Practice Location

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