Ms. Meredith L. Thomas PA-C
Surgical Physician Assistant in Melbourne, FL(View on Map)
Full Name
Ms. Meredith Leigh Thomas PA-C
NPI Number
1093888224
NPI Type
Individual Provider
Gender
Female
Enumeration Date
11/16/2006
Specialties
(Taxonomies)Code
363AS0400X
363AM0700X
Primary Taxonomy
Yes
No
Licenses
State
Florida
New York
Texas
License Number
PA9115907
232558
PA04975
Contact
Information
Purpose
Mailing
Location
Address
3300 S FISKE BLVD
1350 HICKORY ST
City
Rockledge
Melbourne
State
FL
FL
Postal Code
32955-4306
32901-3224
Country
US
US
Telephone Number
N/A
(321) 434-1401
Identifiers
Identifier
208057402
208057401
D07564
TXB149935
327288YV3C
891N49
273899YPWZ
QU188
DQ5280
Unknown
Unknown
Identifier State
TX
VA
TX
TX
TX
TX
TX
FL
TX
Unknown
Unknown
Identifier Issuer
Unknown
Unknown
MEDICARE RR PALMETTO
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
MEDICARE PTAN
BCBS
MEDICARE GROUP PTAN
HFPSI
MEDICARE RR PALMETTO
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 05/16/2023