ACKERMAN CANCER CENTER, PA (NPI# 1013542919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013542919 |
| Entity Type | Organization |
| Organization Name | ACKERMAN CANCER CENTER, PA |
| Practice Address |
10232 San Jose Blvd Jacksonville FL 32257 |
| Practice Telephone | 9044907400 |
| Practice Fax Number | 9044907401 |
| Mailing Telephone | 9044907400 |
| Mailing Fax Number | 9044907401 |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2020-03-11 |
| Authorized Official Name | SCOT N ACKERMAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9042603022 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | ACKERMAN CANCER CENTER, P.A. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Ackerman Urology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700411618 | Ackerman Cancer Center, Pa | Urology | 159 North 3rd St, Macclenny, FL 32063-2103 | 2020-03-11 |
| Street Address |
10232 SAN JOSE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225019680 | Jennifer L Glock | Marriage & Family Therapist | 10232 San Jose Blvd, Jacksonville, FL 32257-6203 | 2005-11-10 |
| 1558561639 | Gary Magee | Counselor | 10232 San Jose Blvd, Jacksonville, FL 32257-6203 | 2007-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740835842 | Majdoline Kasera | Pharmacist | 11250-4 Old St Augustine Rd, Jacksonville, FL 32257 | 2019-08-06 |
| 1386203859 | Jetaime Y Lewis | Physical Therapist | 9765 San Jose Blvd Ste 6, Jacksonville, FL 32257 | 2019-06-10 |
| 1437622107 | Michelle Espanol Garcia | Nurse Practitioner | 9957 Moorings Dr Ste 204, Jacksonville, FL 32257 | 2019-01-05 |
| 1982172995 | Pacifica Augustine Road LLC | Alzheimer Center (Dementia Center) | 10660 Old Augustine Road, Jacksonville, FL 32257 | 2018-11-07 |
| 1659860492 | Andrea Leigh Miller | Social Worker | 10416 Spotted Fawn Lane, Jacksonville, FL 32257 | 2018-05-08 |
| 1376049965 | Stephanie Lynne Jordon | Nurse Practitioner | 9765 San Jose Blvd Ste 102, Jacksonville, FL 32257 | 2018-04-02 |
| 1205335619 | Annetta Aileen Brown | Respite Care | 4901 Sunbeam Rd Apt 1016, Jacksonville, FL 32257 | 2018-02-12 |
| 1841714888 | Freda Stevens | Counselor | 9521 Shellie Road Unit 13, Jacksonville, FL 32257 | 2017-08-01 |
| 1659821353 | Jennifer Lavoro | Acupuncturist | 11259 Thomaston Pl, Jacksonville, FL 32257 | 2016-10-06 |
| 1225488232 | Avenues Dental LLC | Dentist | 6144 Gazebo Park Place South, Ste 210, Jacksonville, FL 32257 | 2016-06-21 |
| Find all providers in zip 32257 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053859041 | Soroush Bazargani | Urology | 653 W 8th St Lrc Bldg Fl 2, Jacksonville, FL 32216-6511 | 2017-02-09 |
| 1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
| 1356692065 | Onslow Ambulatory Services, Inc. | Urology | 52 Office Park Dr, Suite B, Jacksonville, NC 28546-3217 | 2012-09-21 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1275597817 | Thomas L Wilson M D Ltd | Urology | 814 W State, Jacksonville, IL 62650 | 2006-04-12 |
| 1164484267 | Charles Stott Wilson | Urology | 814 West State, Jacksonville, IL 62650 | 2006-04-04 |
| 1912967860 | Fawaz M Ashouri | Urology | 2301 University Blvd W, Jacksonville, FL 32217 | 2006-03-24 |
| 1972578136 | Christopher Ramon Williams | Urology | 8708 Perimeter Park Blvd Ste 4, Jacksonville, FL 32216 | 2006-02-21 |
| 1659374320 | Ahmad Kasraeian | Urology | 6269 Beach Blvd, Ste 2, Jacksonville, FL 32216-2705 | 2005-05-24 |
| 1780241380 | Bryce Baird | Urology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2019-05-20 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32257 |
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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.