Provider Demographics
NPI:1932944949
Name:THOMAS, DEVORIA
Entity type:Individual
Prefix:
First Name:DEVORIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1439 BARTOW RD # 113
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33801-6574
Mailing Address - Country:US
Mailing Address - Phone:863-370-7965
Mailing Address - Fax:
Practice Address - Street 1:1439 BARTOW RD # 113
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33801-6574
Practice Address - Country:US
Practice Address - Phone:863-370-7965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care