Basic Information
Provider Information
NPI: 1003142084
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SINGER
FirstName: THOMAS
MiddleName: JOSEPH
NamePrefix:  
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2600 LAKE LUCIEN DR STE 180
Address2:  
City: MAITLAND
State: FL
PostalCode: 327517235
CountryCode: US
TelephoneNumber: 4078752080
FaxNumber: 4078750518
Practice Location
Address1: 7310 COLLEGE PKWY
Address2:  
City: FORT MYERS
State: FL
PostalCode: 339075503
CountryCode: US
TelephoneNumber: 2397686100
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/26/2009
LastUpdateDate: 10/26/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207N00000XOS10759FLY Allopathic & Osteopathic PhysiciansDermatology 

No ID Information.


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