1487857678 NPI number — MR. THOMAS F OAKLEY L.M.T.

Table of content: MR. THOMAS F OAKLEY L.M.T. (NPI 1487857678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487857678 NPI number — MR. THOMAS F OAKLEY L.M.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OAKLEY
Provider First Name:
THOMAS
Provider Middle Name:
F
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
L.M.T.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OAKLEY
Provider Other First Name:
THOMAS
Provider Other Middle Name:
F
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
L.M.T.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487857678
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 813505
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOLLYWOOD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33081-3505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-987-9609
Provider Business Mailing Address Fax Number:
954-963-7169

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5511 BUCHANAN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOLLYWOOD
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33021-5709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
305-389-6325
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225700000X , with the licence number:  MA0012067 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: WORKER'S COMP . This is a "204287600" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: BCBSFL . This is a "C7069" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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