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Mr. Todd Daniel Thomason

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NPI Number Detailed Information

Provider Information:

Name: Mr. Todd Daniel Thomason
Gender: M
Provider License Number If Given: RN9176643

NPI Information:

NPI: 1912900960
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 5/23/2005

Last Update Date: 7/18/2019

Provider Business Mailing Address:

Address: 2350 N UNIVERSITY DR UNIT 841423
Pembroke Pines, FL 33084
Phone Number: 9543838836
Fax Number:

Provider Business Practice Location Address:

Address: 2350 N UNIVERSITY DR UNIT 841423
Pembroke Pines, FL 33084
Phone Number: 9543838836
Fax Number:

Provider Taxonomy:

Primary: 363L00000X
Secondary (if any):
State: FL

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