JOHN EDWARD KIDDY JR. (NPI# 1013172543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013172543 |
| Entity Type | Individual |
| Full Name | JOHN EDWARD KIDDY JR. |
| Credential | MS, ATC, LAT, CSCS |
| Practice Address |
777 Glades Rd Boca Raton FL 33431-6424 |
| Mailing Address |
3109 San Clara Dr Apt A Delray Beach FL 33445-5430 |
| Practice Telephone | 5612972043 |
| Practice Fax Number | 5612970468 |
| Enumeration Date | 2008-07-24 |
| Last Update Date | 2012-04-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246Z00000X | Specialist/Technologist, Other | AL2789 | FL | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NATABOC CERTIFIED ATHLETIC TRAINER | 03070219 | 01 |
| Street Address |
777 GLADES RD |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33431-6424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760408074 | James Edward Galvin | Psychiatry & Neurology | 777 Glades Rd, Me104, 1st Floor, Boca Raton, FL 33431-6424 | 2006-07-14 |
| 1427674928 | Marie Connell | Nurse Practitioner | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2020-06-19 |
| 1083233175 | Emily Rose Nelson | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Bc71 Room 315, Boca Raton, FL 33431-6496 | 2020-04-09 |
| 1891323085 | Ashley Elizabeth Gureck | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-04-01 |
| 1548896434 | Craig John Robinson Wilder | Preventive Medicine | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2020-03-23 |
| 1265068332 | Rachel Leeann Lewis | Preventive Medicine | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-03-20 |
| 1780210443 | Jared Goldstein | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2020-03-13 |
| 1487203931 | Noah Warren | Dietitian, Registered | 777 Glades Rd, Ss-8w Room 206b, Boca Raton, FL 33431-6496 | 2019-09-07 |
| 1982199428 | Allison Newsome | Specialist/Technologist | 777 Glades Rd, Boca Raton, FL 33431-6496 | 2018-06-27 |
| 1225520901 | Adam Joseph Mann | Student in an Organized Health Care Education/Training Program | 777 Glades Rd, Boca Raton, FL 33431-6424 | 2018-05-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588272868 | Lifegaines Medical and Aesthetics | Preventive Medicine | 3785 N Federal Hwy, Suite 150, Boca Raton, FL 33431 | 2020-07-22 |
| 1285258756 | Gagan Neupane | Student in an Organized Health Care Education/Training Program | Florida Atlantic University At Boca Raton, 670 Glades Road, Suite 400, Boca Raton, FL 33431 | 2020-06-01 |
| 1407477821 | Paramount Medical Specialists | Preventive Medicine | 5550 Glades Road Suite, Ste 500, #1024, Boca Raton, FL 33431 | 2020-04-27 |
| 1497398358 | Dr Beverly Pedroche Inc | Psychologist | 4400 N, Federal Highway, Suite 210-48, Boca Raton, FL 33431 | 2019-10-23 |
| 1649829656 | William I Browning | Psychologist | 4400 North Federal Highway Suite #210, Boca Raton, FL 33431 | 2019-09-11 |
| 1275188898 | East Boca Pharmacy LLC | Pharmacy | 4800 Nw 2nd Ave, Suite 3, Boca Raton, FL 33431 | 2019-08-09 |
| 1790330504 | Connected Warriors | Psychologist | 950 Communications Ave Suite 115, Boca Raton, FL 33431 | 2019-08-08 |
| 1831652734 | Limitless Medical Supplies LLC | Durable Medical Equipment & Medical Supplies | 2263 Nw Boca Blvd, Ste 201, Boca Raton, FL 33431 | 2019-04-09 |
| 1659841211 | Tlc Medical Solutions | Durable Medical Equipment & Medical Supplies | 4800 Nw Boca Raton Blvd Suite 5, Boca Raton, FL 33431 | 2018-11-27 |
| 1750872545 | Sunstate Physicians LLC | Internal Medicine | 2234 N Federal Hwy Ste 531, Boca Raton, FL 33431 | 2018-05-29 |
| Find all providers in zip 33431 | ||||
| Taxonomy Code | 246Z00000X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| General classification identifying individuals trained on specific equipment and technical procedures in one of a collection of miscellaneous healthcare disciplines. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306227269 | Reliable Documents Solutions, LLC | Specialist/Technologist, Other | 902 Clint Moore Rd, Ste 114, Boca Raton, FL 33487-2800 | 2015-06-16 |
| 1760678189 | Edward L Martin | Specialist/Technologist, Other | 5901 Broken Sound Pkwy, Ste. 500, Boca Raton, FL 33487-2773 | 2007-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508476029 | Lauren Elizabeth Linda | Specialist/Technologist, Other | 1110 Airport Blvd Ste B, Pensacola, FL 32504-8608 | 2020-08-10 |
| 1265067839 | Delmar Diagnostics LLC | Specialist/Technologist, Other | 1001 Brickell Bay Dr Ste 2700, Miami, FL 33131-4940 | 2020-03-04 |
| 1518458421 | Brittani Marie Brown | Specialist/Technologist, Other | 4851 Glenburne Dr, Spring Hill, FL 34609-0569 | 2018-05-25 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1538668645 | Victoria Lopez | Specialist/Technologist, Other | 11624 Rouse Run Cir, Orlando, FL 32817-4554 | 2018-02-04 |
| 1811496920 | Kristen M Mendoza | Specialist/Technologist, Other | 108 N Coopers Hawk Way, Palm Coast, FL 32164-2312 | 2018-02-04 |
| 1982103149 | Kristy A Rattanavong I | Specialist/Technologist, Other | 450 Brentwood Club Cv, Longwood, FL 32750-3354 | 2018-02-02 |
| 1205377645 | Alyssa Franco | Specialist/Technologist, Other | 2400 Grand Poplar St, Ocoee, FL 34761-7642 | 2017-03-18 |
| 1497294086 | Roxanne Notte | Specialist/Technologist, Other | 2110 Bayberry Dr, Pembroke Pines, FL 33024-1405 | 2017-02-16 |
| 1750828810 | Maritza De La Caridad Hernandez Perez | Specialist/Technologist, Other | 444 Alemeda Dr, Palm Springs, FL 33461-1504 | 2017-01-27 |
| Find all providers with the same taxonomy | ||||
| City | BOCA RATON |
| Zip Code | 33431 |
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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.