Provider Demographics
NPI:1861886608
Name:THRASHER, MICHAEL J (MD PHD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:J
Last Name:THRASHER
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W CHERRY ST STE A
Mailing Address - Street 2:
Mailing Address - City:KISSIMMEE
Mailing Address - State:FL
Mailing Address - Zip Code:34741-4111
Mailing Address - Country:US
Mailing Address - Phone:407-360-1960
Mailing Address - Fax:407-360-9146
Practice Address - Street 1:1001 W CHERRY ST STE A
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-4111
Practice Address - Country:US
Practice Address - Phone:407-360-1960
Practice Address - Fax:407-360-9146
Is Sole Proprietor?:No
Enumeration Date:2015-03-18
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR19017208D00000X
FLACN941208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLACN941OtherFLORIDA DEPARTMENT OF HEALTH