Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 28341 | FL |
NPI | 1003313958 |
---|---|
Provider Name | Yusuf Patrick Thomas |
First Address | Orlando, FL 32857-0741 |
Second Address | Orlando, FL 32837-8301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2018 |
Last Update Date | 08/04/2018 |