DR. THEODORE G PETTLE


Address: 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539
Phone: 7723359600

DR. THEODORE G PETTLE (NPI# 1003102211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1003102211
Entity Type Individual
Full Name DR. THEODORE G PETTLE
Credential MD
Practice Address 1700 Se Hillmoor Dr
Port St Lucie
FL 34952-7539
Practice Telephone 7723359600
Mailing Telephone 7723359600
Enumeration Date 2011-06-27
Last Update Date 2020-09-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RG0100X Internal Medicine
Specialization: Gastroenterology
ME139195 FL Allopathic & Osteopathic Physicians
N 207RG0100X Internal Medicine
Specialization: Gastroenterology
R6457 TX Allopathic & Osteopathic Physicians

Office Location

Street Address 1700 SE HILLMOOR DR
City PORT ST LUCIE
State FL
Zip Code 34952-7539

Providers in the same location

NPI Name Taxonomy Address Enumeration
1619969573 William A Stolzer Orthopaedic Surgery 1700 Se Hillmoor Dr, Suite 500, Port St Lucie, FL 34952-7536 2005-08-17
1639722176 Naomi Blake Counselor 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2019-07-23
1255864468 Phillip Saeho Son Student in an Organized Health Care Education/Training Program 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2017-04-05
1245763424 Abby Regan Student in an Organized Health Care Education/Training Program 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2017-04-05
1619330537 Hemal Patel Family Medicine 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2016-03-29
1194110304 Mariana Giron Family Medicine 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2015-04-03
1699168864 Emily Sou Pediatrics 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2015-03-12
1710395835 Natasha Williamson Jones Nurse Practitioner 1700 Se Hillmoor Dr, Port St Lucie, FL 34952-7539 2014-08-01
1902230477 Cindy Yuen Family Medicine 1700 Se Hillmoor Dr, Port St Lucie, FL 34952 2013-09-02
1285973107 William Winston Leonard Peterson IIi Chiropractor 1700 Se Hillmoor Dr, Ste 502, Port St Lucie, FL 34952-7566 2013-02-13
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215587068 Carehere LLC Family Medicine Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 2019-09-13
1255998274 Morningside Alf Assisted Living Facility 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 2019-05-24
1336611870 Med Braces and Supplies, LLC Durable Medical Equipment & Medical Supplies 1484 Se Village Green Dr, Port St Lucie, FL 34952 2018-12-21
1689143794 The Gift of Recovery, LLC Counselor 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 2018-11-19
1457830853 Cathy L Sonier Counselor 357 Brazilian Circle, Port St Lucie, FL 34952 2018-08-07
1548756661 Blo 7 Diabetes Institute Inc Nutritionist 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 2018-07-02
1780194464 Doctor's Choice Medical Center Clinic/Center 9164 S Us Highway 1, Port St Lucie, FL 34952 2017-10-06
1801305644 Thandiwe Daley Behavior Technician 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 2017-09-25
1700309408 Lagrand Evan Andrews Assistant Behavior Analyst 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 2017-07-25
1578085148 Lavetta S Ivey Behavior Technician 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 2017-07-14
Find all providers in zip 34952

Taxonomy Information

Taxonomy Code 207RG0100X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Gastroenterology

Taxonomy Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1346453610 Scott E Altschuler Internal Medicine 1701 Se Hillmoor Dr Ste 4, Port St Lucie, FL 34952-7552 2007-05-07
1568416030 Jayshree Matadial Internal Medicine 501 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1615 2006-05-20
1316922511 Khiem Nguyen Internal Medicine 1822 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5545 2005-12-09
1881115343 Treasure Coast Gi LLC Internal Medicine 1701 Se Hillmoor Dr Ste 4, Port St Lucie, FL 34952-7552 2017-07-05
1477888444 Gastroenterology Specialist of The Treasure Coast, Inc Internal Medicine 501 Nw Lake Whitney Pl Ste 102, Port St Lucie, FL 34986-1615 2009-10-08
1518128438 St. Lucie Gastrointestinal Diseases Pl Internal Medicine 1822 Se Port St Lucie Blvd, Port St Lucie, FL 34952-5545 2008-06-23
1053325118 Celso E Pineiro Internal Medicine 1651 Se Tiffany Ave, Port St Lucie, FL 34952-7564 2006-07-27
1043239866 Edwin D. Flanagan Internal Medicine 1651 Se Tiffany Ave, Port St Lucie, FL 34952-7564 2006-07-19
1912940479 Kenneth R Kohen Internal Medicine 1651 Se Tiffany Ave, Port St Lucie, FL 34952-7564 2006-06-13
1265490163 Steven M Kappler Internal Medicine 1651 Se Tiffany Ave, Port St Lucie, FL 34952-7564 2006-05-02
Find all providers in PORT ST LUCIE

Competitor

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City PORT ST LUCIE
Zip Code 34952

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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