Individual
MR. GORDON THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8319 EMBASSY BLVD, PORT RICHEY, FL 34668
(727) 819-0440
(727) 819-9795
Mailing address
8319 EMBASSY BLVD, PORT RICHEY, FL 34668
(727) 819-0440
(727) 819-9795
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OP0002130
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001656500
MEDICAID INDIVIDUAL
FL
01
—
1386690048
MEDICARE NPI
FL
01
—
1518098102
MEDICARE GROUP NPI
FL
01
—
19050
BCBS INDIVIDUAL
—
01
—
19050X
MEDICARE PTAN
FL
01
—
33801
BCBS GROUP
—
01
—
620437600
MEDICAID GROUP
FL
01
—
ECPA-EYE MED
FL2130
—
Enumeration date
05/25/2006
Last updated
06/01/2011
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us