DR. GEORGE OTTO MABRY JR (NPI# 1023079688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023079688 |
| Entity Type | Individual |
| Full Name | DR. GEORGE OTTO MABRY JR |
| Credential | D.P.M. |
| Practice Address |
2194 Hwy A1a Suite 108 Indian Harbour Beach FL 32937-4930 |
| Practice Telephone | 3217779559 |
| Practice Fax Number | 3217779558 |
| Mailing Telephone | 3217779559 |
| Mailing Fax Number | 3217779558 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2016-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213EP1101X |
Podiatrist Specialization: Primary Podiatric Medicine |
PO2788 | FL | Podiatric Medicine & Surgery Service Providers |
| N | 213ER0200X |
Podiatrist Specialization: Radiology |
JR3863700 | FL | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 340672500 | 05 | |
| FL | CIGNA ID # | 0380220001 | 01 |
| FL | AETNA PPO/POS ID # | 7781081 | 01 |
| FL | AETNA HMO/QPOS ID # | 2900719 | 01 |
| FL | BCBS ID | 65612 | 01 |
| Street Address |
2194 HWY A1A SUITE 108 |
| City | INDIAN HARBOUR BEACH |
| State | FL |
| Zip Code | 32937-4930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477769693 | Teresa Ann Harris | Counselor | 2194 Hwy A1a, Suite 203, Indian Harbour Beach, FL 32937-4930 | 2007-05-15 |
| 1518925171 | David Henry Flett | Counselor | 2194 Hwy A1a, Suite 203, Indian Harbour Beach, FL 32937-4930 | 2006-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902407760 | Thalia Mercedes Romero | Occupational Therapy Assistant | 2040 Sr-a1a, Unit 203, Indian Harbour Beach, FL 32937 | 2020-11-06 |
| 1316556616 | Hi 5 Aba Florida Franchise 4 Inc | Behavioral Analyst | 1125 Sr A1a, Suite 306, Satellite Beach, FL 32937 | 2020-07-23 |
| 1154897130 | Sujata S. Balulad, Md., Pa | Internal Medicine | 1095 Highway A1a Apt 2201, Satellite Beach, FL 32937 | 2018-10-17 |
| 1861970782 | Lauren Ann Liston | Pharmacist | 1024 Florida A1a, #120, Satellite Beach, FL 32937 | 2018-08-02 |
| 1184007965 | David Schweibish | Podiatrist | 2020 Highway A1a Ste 101, Indian Harbour Beach, FL 32937 | 2015-06-30 |
| 1831588185 | Cynthia Heyne | Nurse Practitioner | 436 Aruba Ct, Satellite Beach, FL 32937 | 2015-01-09 |
| 1326451675 | Atlantis Urgent Care Inc | Non-Pharmacy Dispensing Site | 2254 Highway Aia, Indian Harbour Beach, FL 32937 | 2014-06-04 |
| 1730511668 | Jessica Lynn Bevins | Occupational Therapy Assistant | 2040 Florida Hwy A1a, Suite 203, Indian Harbour Beach, FL 32937 | 2013-08-02 |
| 1790120582 | Melissa Jean Hamilton | Speech-Language Pathologist | 484 Red Sail Way, Satellite Beach, FL 32937 | 2013-05-07 |
| 1255602637 | Sandra Birza | Pharmacist | 1098 Hwy A I A, Satellite Beach, FL 32937 | 2012-01-18 |
| Find all providers in zip 32937 | ||||
| Taxonomy Code | 213EP1101X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Primary Podiatric Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720324445 | Lisa L Cummings, Dpm, P.a. | Podiatrist | 218a E Eau Gallie Blvd # 163, Indian Harbour Beach, FL 32937-4875 | 2012-12-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912531286 | Samuel S Woociker Dpm Pa | Podiatrist | 445 Warrior Trl, Enterprise, FL 32725-2456 | 2020-02-26 |
| 1467090639 | Ankle Foot and Leg Centers Inc. | Podiatrist | 3075 Chestnut Ridge Way, Orange Park, FL 32065-3629 | 2019-12-18 |
| 1396205423 | Scott Jeffry Blutstein | Podiatrist | 10578 Sw Capraia Way, Port St Lucie, FL 34986-2885 | 2019-03-24 |
| 1265968929 | Northeast Florida Endocrine & Diabetes Associates, Pa | Podiatrist | 11236 Baptist Health Dr, Suite 340, Jacksonville, FL 32218-2980 | 2017-05-02 |
| 1184163784 | Patrick Dennis Martyka | Podiatrist | 4631 Nw 5th Ave, Oakland Park, FL 33309-4002 | 2017-02-15 |
| 1700237799 | Rebecca Desimone | Podiatrist | 6405 N Federal Hwy Ste 405, Ft Lauderdale, FL 33308-1414 | 2016-06-30 |
| 1326403585 | Gentle Care Podiatry, LLC | Podiatrist | 8450 Gate Pkwy W, Unit 1504, Jacksonville, FL 32216-1049 | 2015-12-15 |
| 1528441904 | Zain Barnouti | Podiatrist | 9310 Old Kings S Rd 1201, Jacksonville, FL 32257-6196 | 2015-07-03 |
| 1790188514 | George Zislis | Podiatrist | 1300 Moffett St Apt 201, Hallandale Beach, FL 33009-2718 | 2014-10-07 |
| 1639411648 | Robert George Smith | Podiatrist | 723 Lucerne Cir, Ormond Beach, FL 32174-4624 | 2013-03-18 |
| Find all providers with the same taxonomy | ||||
| City | INDIAN HARBOUR BEACH |
| Zip Code | 32937 |
Please comment or provide details below to improve the information on DR. GEORGE OTTO MABRY JR.
| 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.