Individual
SAMUEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2150 SPENCER RD APT 25A, ORANGE PARK, FL 32073-4238
(904) 891-8410
Mailing address
2150 SPENCER RD APT 25A, ORANGE PARK, FL 32073-4238
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
9641927
FL
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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