DR. PEARL CHU KWONG (NPI# 1043309909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043309909 |
| Entity Type | Individual |
| Full Name | DR. PEARL CHU KWONG |
| Credential | MD PHD |
| Practice Address |
10175 Fortune Pkwy Suite 1203 Jacksonville FL 32256-3519 |
| Practice Telephone | 9045195292 |
| Practice Fax Number | 9045195296 |
| Mailing Telephone | 9045195292 |
| Mailing Fax Number | 9045195296 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
ME 82288 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
10175 FORTUNE PKWY SUITE 1203 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32256-3519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730100587 | Mohammad Farooque | Psychiatry & Neurology | 10175 Fortune Pkwy, Suite #1106, Jacksonville, FL 32256-6746 | 2006-07-21 |
| 1902430614 | Delana Dampier | Technician | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2020-03-03 |
| 1336780907 | Sunshine Medical Specialists, LLC | Pediatrics | 10175 Fortune Pkwy, Jacksonville, FL 32256-6746 | 2019-10-03 |
| 1376079905 | Ashley Raynor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-05-02 |
| 1952834434 | Mollie Gibson | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-11 |
| 1720511728 | Desiree Adams | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-04-06 |
| 1538691555 | Meghan Rhegness | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2017-03-29 |
| 1568906048 | Alicia Miller | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-19 |
| 1417491036 | Mary Moore | Behavioral Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
| 1720522352 | Lavyn Taylor | Assistant Behavior Analyst | 10175 Fortune Pkwy, Suite 903, Jacksonville, FL 32256-6746 | 2016-12-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
| 1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
| 1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
| 1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
| 1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
| 1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
| 1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
| Find all providers in zip 32256 | ||||
| Taxonomy Code | 207NP0225X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Pediatric Dermatology |
| A pediatric dermatologist has, through additional special training, developed expertise in the treatment of specific skin disease categories with emphasis on those diseases which predominate in infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: changed definition, added source] Additional Resources: American Board of Dermatology, 2007, http://www.abderm.org/ A subspecialty certificate was approved by ABMS in 2000. ACGME Accredited Residency Program Requirements: None. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144855172 | Young Skin, P.a. | Dermatology | 5200 S University Dr Ste 102, Davie, FL 33328-5316 | 2020-03-10 |
| 1942238258 | Children's Skin Center Pa | Dermatology | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2006-06-28 |
| 1053365429 | Andrew M Margileth | Dermatology | 1611 Nw 12th Ave, Miami, FL 33136-1005 | 2006-05-20 |
| City | JACKSONVILLE |
| Zip Code | 32256 |
Please comment or provide details below to improve the information on DR. PEARL CHU KWONG.
| 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.