Organization
THOMAS WEIGHT LOSS MANAGEMENT SYSTEM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY M THOMAS M.D. (PHYSICIAN)
(813) 597-0202
Entity
Organization
Contact information
Practice address
12015 WHITMARSH LN, TAMPA, FL 33626-1737
(813) 597-0202
(813) 425-9043
Mailing address
12015 WHITMARSH LN, TAMPA, FL 33626-1737
(813) 597-0202
(813) 425-9043
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
ME82489
FL
261QP2300X
Primary Care Clinic/Center
ME82489
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04002
BCBS OF FLORIDA
FL
01
—
222672
AMEDRIGROUP
FL
05
—
263232200
—
FL
01
—
514769328
CHAMPUS
FL
01
—
P00289057
RAILROAD MEDICARE
FL
Enumeration date
01/23/2008
Last updated
01/27/2009
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