Provider Demographics
NPI:1720074693
Name:THOMAS, NEZBILE F (NP)
Entity type:Individual
Prefix:MS
First Name:NEZBILE
Middle Name:F
Last Name:THOMAS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:DR
Other - First Name:NEZBILE
Other - Middle Name:F
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP,APRN
Mailing Address - Street 1:288 VESTRELLA DR
Mailing Address - Street 2:
Mailing Address - City:POINCIANA
Mailing Address - State:FL
Mailing Address - Zip Code:34759-4456
Mailing Address - Country:US
Mailing Address - Phone:863-496-7945
Mailing Address - Fax:
Practice Address - Street 1:118301 BOYS RANCH RD
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:FL
Practice Address - Zip Code:32707
Practice Address - Country:US
Practice Address - Phone:352-308-3248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002956363L00000X
AZAP8405363L00000X
FL9424035363LF0000X
WAAP60691558363L00000X
CT002596363LF0000X
TXAP13897363LF0000X
NYF333681-1363LF0000X
RIAPRN01342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT500000837Medicare ID - Type Unspecified