Individual
ZACHARY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1995 E OAKLAND PARK BLVD STE 310, FORT LAUDERDALE, FL 33306-1138
(954) 791-6146
Mailing address
PO BOX 936535, ATLANTA, GA 31193-6535
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
A00512
MD
363A00000X
Physician Assistant
9636
GA
363A00000X
Physician Assistant
C0008128
MD
363A00000X
Physician Assistant
PA9117178
FL
363AS0400X
Surgical Physician Assistant
Primary
PA9117178
FL
Other
Enumeration date
07/08/2013
Last updated
03/08/2023
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