Provider Demographics
NPI:1992265789
Name:FRAUENHOFER, THOMAS (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:FRAUENHOFER
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4012 KELCEY CT STE 202
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-5986
Mailing Address - Country:US
Mailing Address - Phone:850-559-2355
Mailing Address - Fax:954-755-0243
Practice Address - Street 1:4012 KELCEY CT STE 202
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-5986
Practice Address - Country:US
Practice Address - Phone:850-559-2355
Practice Address - Fax:800-443-1468
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS18631207P00000X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine