Provider Demographics
NPI:1942615133
Name:THOMAS, FELICIA CELETTE (CPT)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:CELETTE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CPT
Other - Prefix:MRS
Other - First Name:FELICIA
Other - Middle Name:CELETTE
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPT
Mailing Address - Street 1:PO BOX 6472
Mailing Address - Street 2:
Mailing Address - City:SEFFNER
Mailing Address - State:FL
Mailing Address - Zip Code:33583-6472
Mailing Address - Country:US
Mailing Address - Phone:813-369-4249
Mailing Address - Fax:813-831-5133
Practice Address - Street 1:7402 N 56TH ST STE 710
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-7745
Practice Address - Country:US
Practice Address - Phone:813-769-9235
Practice Address - Fax:888-831-5133
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-25
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL20-0029R14246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy