Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | ME118733 | FL |
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | ME 118733 | FL |
NPI | 1851525364 |
---|---|
Provider Name | Thomas Howard Sanders |
First Address | Temple Terrace, FL 33637-0925 |
Second Address | Temple Terrace, FL 33637-0925 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2009 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
012394100 | (05) | FL |
14U5L | FLORIDA BLUE (01) | |
4863389 | AETNA (01) |