Individual
JERRY G THOMAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3429 57TH AVENUE DR W, BRADENTON, FL 34210-3518
(785) 243-0454
Mailing address
3429 57TH AVENUE DR W, BRADENTON, FL 34210-3518
(785) 243-0454
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
54616
KS
367500000X
Certified Registered Nurse Anesthetist
Primary
9355144
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331300G
—
KS
Enumeration date
05/23/2005
Last updated
02/23/2015
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