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
Fax: (239) 574-1435
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891777090 NPPES
Florida MEDICAID 269265100
Florida Other 241387
Florida Other 294225
Florida Other 000013683G
Florida Other 37718

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