Provider Demographics
NPI:1689072480
Name:THOMAS, RIAN
Entity type:Individual
Prefix:MS
First Name:RIAN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7031 GRAND NATIONAL DR
Mailing Address - Street 2:103
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819-8984
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7031 GRAND NATIONAL DR
Practice Address - Street 2:103
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8984
Practice Address - Country:US
Practice Address - Phone:407-674-7673
Practice Address - Fax:407-674-8276
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator