Provider Demographics
NPI:1730546151
Name:THOMAS, ALYSON (PA-C)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 SEBRING PKWY
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-1615
Mailing Address - Country:US
Mailing Address - Phone:863-314-9308
Mailing Address - Fax:863-471-0084
Practice Address - Street 1:1027 SEBRING PKWY
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-1615
Practice Address - Country:US
Practice Address - Phone:863-314-9308
Practice Address - Fax:863-471-0084
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 9109234363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPA9109234OtherSTATE OF FLORIDA
ALPA.1091OtherSTATE OF ALABAMA