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Ashanti Janea Thomas

NPI Registration Record

Provider / OrganizationNPIDate Certified
ASHANTI JANEA THOMAS16094748652020-10-10
Entity TypeIndividual
Provider Name Ashanti Janea Thomas
Practice Office Address4320 SUNBEAM RD APT 315
JACKSONVILLE, FL US
Practice Office Telephone9042362328
Mailing Address4320 SUNBEAM RD APT 315
JACKSONVILLE, FL 322578829 US
Business Telephone9042362328
HPT Codes
CodeLicense NoState
372500000X
372600000X PRIMARY237006 FL
376J00000X237006 FL
OPI Codes
108121000 MEDICAID FL

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