JEREMY GANZ (NPI# 1053805671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053805671 |
| Entity Type | Individual |
| Full Name | JEREMY GANZ |
| Credential | PA |
| Practice Address |
283 Twin Lakes Ln Destin FL 32541-2866 |
| Practice Telephone | 9203921263 |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| Street Address |
283 TWIN LAKES LN |
| City | DESTIN |
| State | FL |
| Zip Code | 32541-2866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578020574 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | Sec of Hwy 98 and Gulf Shore Drive, Destin, FL 32541 | 2019-02-26 |
| 1932640471 | Kathryn Clower | Chiropractor | 36474c Emerald Coast Pkwy Ste 3101, Destin, FL 32541 | 2017-03-16 |
| 1881133148 | Danielle Mckinney | Physical Therapist | 35008 Emerald Coast Pkwy Ste 400, Destin, FL 32541 | 2017-02-20 |
| 1417304643 | Coastal Pediatric Group | Pediatrics | 36468 Emerald Coast Pkwy Unit 2101, Destin, FL 32541 | 2016-05-17 |
| 1336563956 | Blu By The Sea,llc | Clinic/Center | 3399 Scenic Highway 98, Destin, FL 32541 | 2014-02-18 |
| 1740539535 | Courtney Breaux Mcgee | Physician Assistant | 155 Crystal Beach Drive #121, Destin, FL 32541 | 2012-09-07 |
| 1073861704 | Nathan Hall Dmd Pl | Dentist | 4484 Legendary Dr, Suite B, Destin, FL 32541 | 2012-08-28 |
| 1982991121 | Bayshore Retreat, LLC | Substance Abuse Rehabilitation Facility | 457 Cahoun Ave, Destin, FL 32541 | 2011-07-08 |
| 1457661605 | Destin Surgery Clinic, P.a. | Specialist | 415 Mountain Drive, Suite # 6, Destin, FL 32541 | 2010-10-20 |
| 1194032581 | Laura Mathisen | Behavioral Analyst | 3820 Misty Way, Destin, FL 32541 | 2010-09-07 |
| Find all providers in zip 32541 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872387 | Wesley Charles Wagers | Military Health Care Provider | 96 Mdos/sgof, 307 Boatner Road, Suite 114, Eglin Afb, FL 32542-1391 | 2020-05-14 |
| 1548808546 | Patrick S. Merriman | Military Health Care Provider | Navy Medicine Support Command Att: Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-12-20 |
| 1023656451 | Operation Art District Healthcare LLC | Military Health Care Provider | 11 Nottingham Pl, Boynton Beach, FL 33426-8427 | 2019-12-17 |
| 1245881994 | Matthew Kerwin Church | Military Health Care Provider | 2020 Glenwood Hammock Rd, Deland, FL 32720-3805 | 2019-09-24 |
| 1326512443 | Francine Dorce I | Military Health Care Provider | 2300 Lynbrooke View Ct Apt 4, Orlando, FL 32822-4624 | 2019-01-12 |
| 1093224388 | Roland Vaughn | Military Health Care Provider | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2017-09-29 |
| 1134644750 | Kwanza Lincoln | Military Health Care Provider | 3520 Zemke Ave, Tampa, FL 33621 | 2017-08-04 |
| 1134576390 | Nathan Jamal Pena | Military Health Care Provider | 1320 Bailey Ave, Jacksonville, FL 32228-0028 | 2016-05-18 |
| 1780063644 | Samuel Herman | Military Health Care Provider | Naval Hospital Pensacola 6000 Us-98, Pensacola, FL 32512-0001 | 2015-05-26 |
| 1659612240 | Andrew J Wright | Military Health Care Provider | Naval Hospital Pensacola 6000 Us-98 Hwy, Pensacola, FL 32512 | 2013-03-07 |
| Find all providers with the same taxonomy | ||||
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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.