Eddrena Thornton, OWNER

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6907032 Issued in FL

Practice address

2233 Bluebird Ave
Bartow, FL 33830-2953

Phone

(863) 529-3103

NPI assigned

Oct 9, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1602201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602288000000",
    "number": "1336747658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 BLUEBIRD AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338302953",
            "telephone_number": "863-529-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 BLUEBIRD AVE",
            "city": "BARTOW",
            "state": "FL",
            "postal_code": "338302953",
            "telephone_number": "863-529-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "EDDRENA",
        "credential": "OWNER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-09",
        "last_updated": "2020-10-10",
        "certification_date": "2020-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6907032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terrence S. Delikat, DO, P.L.
• The Mid-Florida Center, Inc.
• James J Thoene Jr., M.D.
• Shemmer Thomas
• Usha Thombre, OTR
• Lynn Throtman
• Robin Thurman
• Marion Vincent Tolley Jr., ARNP
• Triad Clinical Bodywork & Massage
• Carmen Trindade-Sueldo, PHARMD

• Adult Care Home Facility in Bartow, FL
• Providers in Bartow, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.