EUGENE E WENTHE JR. (NPI# 1003826918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003826918 |
| Entity Type | Individual |
| Full Name | EUGENE E WENTHE JR. |
| Credential | M.D. |
| Practice Address |
1223 Gateway Dr Ste 1e Melbourne FL 32901-2607 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3217254505 |
| Practice Fax Number | 3214096823 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2018-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME117071 | FL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 036061047 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | IL STATE LICENSE | 036061047 | 01 |
| IL | RR MEDICARE GROUP | CD7143 | 01 |
| IL | PERSONAL CARE | 170774 | 01 |
| IL | RR MEDICARE PIN | 080098256 | 01 |
| IL | CATERPILLAR | 6394P | 01 |
| IL | BLACK LUNG | 020057300 | 01 |
| IL | HEALTHLINK | 101343 | 01 |
| IL | CLIA | 14D0949277 | 01 |
| IL | BC/BS | 08421024 | 01 |
| IL | 036061047 | 05 | |
| IL | HEALTH ALLIANCE | 054913 | 01 |
| IL | ACS-OWCP | 133586700 | 01 |
| Street Address |
1223 GATEWAY DR STE 1E |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235121567 | Deborah Morrison-metz | Family Medicine | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2005-08-23 |
| 1881226785 | Urgent Care Centers of Brevard County LLC | Clinic/Center | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2020-02-08 |
| 1982198586 | Letitia Krieg | Audiologist | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2018-06-18 |
| 1205296407 | Christian Adam Kendrick | Nurse Practitioner | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2016-03-01 |
| 1144687534 | Alexis Best | Physician Assistant | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2016-01-15 |
| 1609249499 | Alex Sher | Nurse Practitioner | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2015-11-03 |
| 1588076087 | Cassie Krause Kornhauser | Nurse Practitioner | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2014-06-02 |
| 1033494604 | Danielle N Miller | Physician Assistant | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2011-10-14 |
| 1407148950 | Namita Murthy | Otolaryngology | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2011-05-03 |
| 1841488277 | Ana Lucia Restrepo | Family Medicine | 1223 Gateway Dr Ste 1e, Melbourne, FL 32901-2607 | 2007-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970277 | Kimberly Gayle Ross | Family Medicine | 1919 Slone Blvd, Melbourne, FL 32935-4756 | 2020-07-28 |
| 1245706423 | Vargas Medical Services LLC | Family Medicine | 606 Sheridan Rd, Melbourne, FL 32901-3227 | 2018-10-16 |
| 1013467554 | First Locums Inc | Family Medicine | 3248 Cortona Dr, Melbourne, FL 32940-8613 | 2016-10-07 |
| 1922327774 | Angela Matthews | Family Medicine | 2694 Judge Fran Jamieson Way, Overflow Parking Lot, Melbourne, FL 32940 | 2010-05-19 |
| 1013197201 | Lauren Romeo Md Pa | Family Medicine | 1698 W Hibiscus Blvd Ste B, Melbourne, FL 32901-2639 | 2007-11-06 |
| 1023220605 | Marta Cyzio | Family Medicine | 1368 Tipperary Dr, Melbourne, FL 32940-6030 | 2007-05-04 |
| 1578787941 | Donna J. Badolato, Md, Pa | Family Medicine | 8061 Spyglass Hill Rd., Suite 102, Melbourne, FL 32940 | 2007-04-13 |
| 1801914858 | Marilyn C. Moss, M.d. | Family Medicine | 3210 N Wickham Rd, Suite 1, Melbourne, FL 32935-2300 | 2007-03-27 |
| 1639217870 | Kenneth Robert Mcelynn | Family Medicine | 7925 N Wickham Rd Ste B, Melbourne, FL 32940-8211 | 2007-02-01 |
| 1760568935 | Kristine R Everding | Family Medicine | 2002 Pennwood Dr, Melbourne, FL 32901-5934 | 2006-10-31 |
| Find all providers in MELBOURNE | ||||
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| 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.