Bode, Thomas Lee

Bode, Thomas Lee is an individual health care provider with primary practice located at 27 Parkway Dr , Palm Coast FL 32164-2801. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Bode, Thomas Lee can be contacted via phone (606) 209-3186.

Contact Information

Primary practice address
27 Parkway Dr Palm Coast FL 32164-2801
Phone: (606) 209-3186
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X ARNP 9211289 Florida

Profile Details

NPI number 1437158995
LBN Legal business name Bode, Thomas Lee
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2005
Last updated Nov 11th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437158995 NPPES
Ohio MEDICAID 2341817
Ohio MEDICAID 200510690
Ohio MEDICAID 74010687
Ohio Other G3836A
Ohio Other 4-0029230
Ohio Other 000000356339

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