Individual
DR. BRENTON DAVID THRASHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
811 S J ST, LAKE WORTH, FL 33460-5043
(561) 200-9944
(561) 200-9944
Mailing address
811 S J ST, LAKE WORTH, FL 33460-5043
(561) 200-9944
(561) 200-9944
Taxonomy
Speciality
Code
Description
License number
State
207RA0401X
Addiction Medicine (Internal Medicine) Physician
ME77922
FL
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
ME77922
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275846800
GROUP NPI
—
01
—
46787Y
MEDICARE PTAN
FL
Enumeration date
12/07/2006
Last updated
08/14/2011
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