Provider Demographics
NPI:1063714632
Name:DR THOMAS A MAGUIRE PA
Entity type:Organization
Organization Name:DR THOMAS A MAGUIRE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:AQUINAS
Authorized Official - Last Name:MAGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:305-693-0033
Mailing Address - Street 1:2825 E 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33013-3229
Mailing Address - Country:US
Mailing Address - Phone:305-693-0033
Mailing Address - Fax:305-693-8362
Practice Address - Street 1:2825 E 4TH AVE
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33013-3229
Practice Address - Country:US
Practice Address - Phone:305-693-0033
Practice Address - Fax:305-693-8362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-02
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0004171111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050376200Medicaid
FL88988Medicare PIN
FL050376200Medicaid