Organization
SEBASTIAN ID CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA THOMAS MD (OWNER)
(313) 832-2590
Entity
Organization
Contact information
Practice address
7955 BAY ST, SUITE 2, SEBASTIAN, FL 32958-3282
(313) 832-2590
Mailing address
7955 BAY ST, SUITE 2, SEBASTIAN, FL 32958-3282
(313) 832-2590
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME115531
FL
Other
Enumeration date
10/02/2015
Last updated
10/02/2015
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