DR. RAPHAEL ALEXANDER RUSYNYK (NPI# 1023047297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1023047297 |
Entity Type | Individual |
Full Name | DR. RAPHAEL ALEXANDER RUSYNYK |
Credential | D.O. |
Practice Address |
417a Racetrack Rd Nw Ste 2 Fort Walton Beach FL 32547-4604 |
Practice Telephone | 8508635990 |
Practice Fax Number | 8508620041 |
Mailing Telephone | 8508635990 |
Mailing Fax Number | 8508620041 |
Enumeration Date | 2006-07-01 |
Last Update Date | 2020-09-18 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
OS8902 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 266728200 | 05 |
Street Address |
417A RACETRACK RD NW STE 2 |
City | FORT WALTON BEACH |
State | FL |
Zip Code | 32547-4604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
Find all providers in zip 32547 |
Taxonomy Code | 207RG0100X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Gastroenterology |
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. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346225240 | Charles Mark Riggenbach | Internal Medicine | 1032 Mar Walt Drive, Suite 210, Gastroenterology Department, Fort Walton Beach, FL 32547 | 2005-12-13 |
1669723029 | Leena Chacko Saline | Internal Medicine | 928b Mar Walt Dr, Fort Walton Beach, FL 32547 | 2012-09-26 |
1164687042 | Tri Huu Huynh | Internal Medicine | 928b Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2008-07-21 |
1457442741 | Andrew Franklin Ringel | Internal Medicine | 417a Racetrack Rd Nw, Suite 2, Fort Walton Beach, FL 32547-4600 | 2006-09-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093321382 | Charlotte Harbor Gastroenterology LLC | Internal Medicine | 2811 Tamiami Trl Ste I, Port Charlotte, FL 33952-5135 | 2020-09-22 |
1750907614 | Michael G. Valladares D.o. P.a. | Internal Medicine | 10302 Sw 116th St, Miami, FL 33176-4049 | 2020-06-17 |
1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
1750922399 | Gastroenterology Care Specialists, LLC | Internal Medicine | 550 Redstone Ave W Ste 430, Crestview, FL 32536-6457 | 2019-10-04 |
1194375378 | Digestive and Liver Disease Institute of Florida, LLC | Internal Medicine | 505 W Oak St Ste 202, Kissimmee, FL 34741-4986 | 2019-09-18 |
1659833002 | Steven L Diamond | Internal Medicine | 5606 Vintage Oaks Terrace, Delray Beach, FL 33484 | 2019-04-04 |
1225507601 | Linmec Corp | Internal Medicine | 4531 Deleon St Ste 215, Fort Myers, FL 33907-1279 | 2018-11-15 |
1912474156 | Eileen E Kim | Internal Medicine | 5117 Fiorella Ln, Sanford, FL 32771-5449 | 2018-10-25 |
1790251197 | Gabriel Benitez | Internal Medicine | 2330 Wilton Dr, Wilton Manors, FL 33305-1249 | 2018-10-23 |
1043786833 | Union Medical Group | Internal Medicine | 6300 Corporate Ct Ste 105, Fort Myers, FL 33919-3513 | 2018-10-18 |
Find all providers with the same taxonomy |
City | FORT WALTON BEACH |
Zip Code | 32547 |
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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.