Provider Demographics
NPI:1053155333
Name:THOMAS, SHAKEMA S (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:SHAKEMA
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:F
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 371751
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-1751
Mailing Address - Country:US
Mailing Address - Phone:786-443-0970
Mailing Address - Fax:
Practice Address - Street 1:4300 BISCAYNE BLVD STE 203
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3255
Practice Address - Country:US
Practice Address - Phone:786-936-0011
Practice Address - Fax:786-590-1919
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-21
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory