Provider Demographics
NPI:1528530417
Name:THOMAS, ELEZABATH SONIA (PT)
Entity type:Individual
Prefix:
First Name:ELEZABATH
Middle Name:SONIA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5414 TOWN N COUNTRY BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4120
Mailing Address - Country:US
Mailing Address - Phone:813-886-4395
Mailing Address - Fax:813-886-6959
Practice Address - Street 1:5414 TOWN N COUNTRY BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4120
Practice Address - Country:US
Practice Address - Phone:813-886-4395
Practice Address - Fax:813-886-6959
Is Sole Proprietor?:No
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32143225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist