DR. CURTIS E DEDRICK (NPI# 1023012978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023012978 |
| Entity Type | Individual |
| Full Name | DR. CURTIS E DEDRICK |
| Credential | DO |
| Practice Address |
21297 Olean Blvd Ste A Port Charlotte FL 33952-6704 |
| Mailing Address |
2675 Winkler Ave Fl 2 Fort Myers FL 33901-9342 |
| Practice Telephone | 8559795700 |
| Mailing Telephone | 8778563774 |
| Enumeration Date | 2005-06-09 |
| Last Update Date | 2019-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | OS10071 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBSM | 700H270060 | 01 |
| MI | 4171893111 | 05 | |
| MI | CONTROLLED SUBSTANCE | 5101013115 | 01 |
| MI | CONTROLLED SUBSTANCE | BD6425501 | 01 |
| Street Address |
21297 OLEAN BLVD STE A |
| City | PORT CHARLOTTE |
| State | FL |
| Zip Code | 33952-6704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497398606 | Bernadette Serafini | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2019-10-21 |
| 1336703974 | Meghan Nicole Jackson | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2019-04-29 |
| 1689160913 | Glodene Simone Roberts | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2018-07-10 |
| 1417457425 | Nicholas John Newbold Jr. | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2018-02-16 |
| 1245771815 | Pouria Haghighi Tajvar | Internal Medicine | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2017-03-16 |
| 1639520083 | Gabrielly Meurer Coatti | Internal Medicine | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2016-06-27 |
| 1255787370 | Monette Audath | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2016-05-07 |
| 1609230119 | Victor Manuel Pena | Family Medicine | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2016-04-11 |
| 1295196863 | James Ramirez | Nurse Practitioner | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2016-03-10 |
| 1952771347 | Denise Nicole Dampier | Physician Assistant | 21297 Olean Blvd Ste A, Port Charlotte, FL 33952-6704 | 2015-09-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700486552 | Arrow Medical LLC | Durable Medical Equipment & Medical Supplies | 3514 Tamiami Trail, Unit 104, Port Charlotte, FL 33952 | 2020-10-30 |
| 1376009621 | David Alan Mowry | Massage Therapist | 3148 Whiting Lane, Port Charlotte, FL 33952 | 2019-02-12 |
| 1124527189 | Aegis Group Practice, LLC | Physical Therapist | 2500 Aaron Street, Port Charlotte, FL 33952 | 2018-02-06 |
| 1255856118 | All Powered Mobility, LLC | Durable Medical Equipment & Medical Supplies | 2765 Tamiami Trl Ste B1, Port Charlotte, FL 33952 | 2017-08-11 |
| 1366994915 | Julianne Kumar | Physical Medicine & Rehabilitation | 4166 Tamiami Trail, Unit A, Port Charlotte, FL 33952 | 2016-10-31 |
| 1659729549 | The Gathering Place LLC | Licensed Practical Nurse | 3459 Depew Ave, Port Charlotte, FL 33952 | 2016-06-01 |
| 1003222183 | Philip Lagamma | Physical Therapist | 4161 Tamiami Trl Ste 103, Port Charlotte, FL 33952 | 2014-07-09 |
| 1184039695 | Nathan E Shipley | Driver | 2338 Alton Rd., Port Charlotte, FL 33952 | 2014-06-23 |
| 1619318219 | Nic 4 Royal Palm Leasing LLC | Assisted Living Facility | 2500 Aaron St., Port Charlotte, FL 33952 | 2013-07-11 |
| 1225306475 | Tamjo Inc | Hearing Instrument Specialist | 2811 Ste. A Tamiami Trail, Port Charlotte, FL 33952 | 2011-12-02 |
| Find all providers in zip 33952 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639613300 | Kalyani Regeti | Internal Medicine | 3611 Tamiami Trl Ste B, Port Charlotte, FL 33952-5508 | 2016-12-14 |
| 1740601731 | Peace of Mind Internal Medicine Pllc Jennifer A Cooke Sole Mbr | Internal Medicine | 1675 Tamiami Trl, Ste 5, Port Charlotte, FL 33948-1042 | 2013-12-18 |
| 1912291725 | Sanjeev Zutshi Pa | Internal Medicine | 3390 Tamiami Trl Ste 105, Port Charlotte, FL 33952-8161 | 2011-06-09 |
| 1033354873 | Chitradeep De | Internal Medicine | 2852 Tamiami Trl Ste 4, Port Charlotte, FL 33952-5100 | 2008-12-09 |
| 1083864474 | Mario E Carbonell Md Pa | Internal Medicine | 17912 Toldeo Blade Blvd Ste A, Port Charlotte, FL 33948-1042 | 2008-09-23 |
| 1902087810 | Juan C Torres-urrutia Md Pa | Internal Medicine | 21202 Olean Blvd Ste C1, Port Charlotte, FL 33952-6725 | 2007-11-19 |
| 1659551356 | Aneley Yegezu Hundae | Internal Medicine | 3161 Harbor Blvd Ste A, Port Charlotte, FL 33952-6754 | 2007-11-09 |
| 1336338870 | Rias Ali, Md, Pa | Internal Medicine | 23362 Duchess Ave, Port Charlotte, FL 33954-2500 | 2007-10-22 |
| 1235321639 | Brian D Ardel Md Pa | Internal Medicine | 3417 Tamiami Trl Ste D, Port Charlotte, FL 33952-8158 | 2007-08-10 |
| 1649489014 | Arthur R Ballard II | Internal Medicine | 23081 Harborview Rd, Port Charlotte, FL 33980-2153 | 2007-05-22 |
| Find all providers in PORT CHARLOTTE | ||||
| City | PORT CHARLOTTE |
| Zip Code | 33952 |
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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.