Thomas, Jerry Von
Thomas, Jerry Von is an sole proprietor health care provider with primary practice located at 1255 Viscaya Pkwy Suite 200, Cape Coral FL 33990-3290. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Thomas, Jerry Von can be contacted via phone (239) 574-1988.Contact Information
Primary practice address
1255 Viscaya Pkwy Suite 200
Cape Coral FL 33990-3290
Phone: (239) 574-1988
Fax: (239) 574-1435
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ME86901 | Florida |
Profile Details
| NPI number | 1891777090 |
|---|---|
| LBN Legal business name | Thomas, Jerry Von |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2005 |
| Last updated | Aug 21st, 2020 - about 4 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891777090 | NPPES |
| Florida | MEDICAID | 269265100 | |
| Florida | Other | 241387 | |
| Florida | Other | 294225 | |
| Florida | Other | 000013683G | |
| Florida | Other | 37718 |
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