Provider Demographics
NPI:1699074609
Name:VANHYNING, THOMPSON JR (PA)
Entity type:Individual
Prefix:
First Name:THOMPSON
Middle Name:
Last Name:VANHYNING
Suffix:JR
Gender:M
Credentials:PA
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2600 LAKE LUCIEN DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-7233
Mailing Address - Country:US
Mailing Address - Phone:407-875-2080
Mailing Address - Fax:407-875-0518
Practice Address - Street 1:1918 SE 17TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4120
Practice Address - Country:US
Practice Address - Phone:352-620-2420
Practice Address - Fax:352-620-2935
Is Sole Proprietor?:No
Enumeration Date:2011-03-17
Last Update Date:2011-07-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9105899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant