Provider Demographics
NPI:1467427575
Name:KASS, THOMAS J (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:KASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:900 SE OCEAN BLVD
Mailing Address - Street 2:SUITE 220 C
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-2471
Mailing Address - Country:US
Mailing Address - Phone:772-781-4454
Mailing Address - Fax:772-781-7607
Practice Address - Street 1:900 SE OCEAN BLVD
Practice Address - Street 2:SUITE 220 C
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2471
Practice Address - Country:US
Practice Address - Phone:772-781-4454
Practice Address - Fax:772-781-7607
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL0050754207R00000X
CODR.0058048207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL04445BMedicare ID - Type UnspecifiedMEDICARE
FLD61087Medicare UPIN