Thomas P Broner, D.P.M.
Podiatrist, Foot & Ankle Surgery in Jacksonville, FL. Individual provider (NPI-1).
NPI number1790740314
StatusActive
Last updated in NPPESApr 17, 2024
Details
- NPI
- 1790740314
- Entity type
- Individual (NPI-1)
- Name
- Thomas P Broner
- Credential
- D.P.M.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2006
- Certification date
- Apr 17, 2024
- Last updated
- Apr 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 213ES0103X | Podiatrist, Foot & Ankle Surgery | PO0924 | FL | Yes |
| 213E00000X | Podiatrist | PO924 | FL |
Practice location
5301 Pine Notch PlJacksonville, FL 32224-4411
Phone 904-472-6536 · Fax 904-895-6056
Mailing address
5301 Pine Notch PlJacksonville, FL 32224-4411
Phone 904-251-5053 · Fax 904-895-6056
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