Individual
DR. DAMITA L. THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Mailing address
52 W UNDERWOOD ST, ORLANDO, FL 32806-1110
(321) 842-8475
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
ME 108980
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003929900
—
FL
01
—
14H70
BCBS
FL
01
—
FH175X
MEDICARE PTAN OHRI
FL
01
—
PS578
MEDICARE PTAN OHMG
FL
Enumeration date
07/20/2007
Last updated
03/28/2023
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