Broner, Thomas P

Broner, Thomas P is an individual health care provider with primary practice located at 5301 Pine Notch Pl , Jacksonville FL 32224-4411. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery is his primary health care specialty. Broner, Thomas P can be contacted via phone (904) 472-6536.

Contact Information

Primary practice address
5301 Pine Notch Pl Jacksonville FL 32224-4411
Phone: (904) 472-6536
Fax: (904) 895-6056
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X PO924 Florida
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X PO0924 Florida

Profile Details

NPI number 1790740314
LBN Legal business name Broner, Thomas P
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Apr 17th, 2024 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790740314 NPPES
Florida MEDICAID 041050100

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