DR. ERIC LEE CEITHAML (NPI# 1063485506) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063485506 |
| Entity Type | Individual |
| Full Name | DR. ERIC LEE CEITHAML |
| Credential | M.D. |
| Practice Address |
836 Prudential Dr Ste 802 Jacksonville FL 32207-8335 |
| Mailing Address |
Po Box 44047 Jacksonville FL 32231-4047 |
| Practice Telephone | 9042028290 |
| Practice Fax Number | 9042028171 |
| Mailing Telephone | 9043764083 |
| Mailing Fax Number | 9043915075 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2018-10-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | ME50651 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000367617A | 05 | |
| FL | 0457868-00 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 Prudential Dr, Suite 202 / Ufjp Wolfson's, Jacksonville, FL 32207 | 9042028290 | 9042028171 |
| Street Address |
836 PRUDENTIAL DR STE 802 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710504725 | Gladys Elena Hatem | Nurse Practitioner | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2020-06-25 |
| 1730427352 | Sheri Renee Dorner | Nurse Practitioner | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2013-01-17 |
| 1811157993 | Harma Khachig Turbendian | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2008-06-12 |
| 1639299936 | Michael Selim Shillingford | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2007-03-30 |
| 1700950474 | Shamsur Rahman Chowdhury | Pediatrics | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2006-11-17 |
| 1437109063 | Melissa Griffin Tyler | Nurse Practitioner | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2006-05-12 |
| 1144295684 | Pamela Fran Stanger | Nurse Practitioner | 836 Prudential Dr Ste 802, Jacksonville, FL 32207-8335 | 2006-02-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184063521 | Walter Smithwick IIi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4708 Prince Edward Rd, Jacksonville, FL 32210-8118 | 2013-06-19 |
| 1699081356 | Giancarlo Bertozzi Md Pa | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3599 University Blvd S Ste 802, Jacksonville, FL 32216-4258 | 2010-08-19 |
| 1881763704 | Vasant Jayasankar | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 836 Prudential Dr Ste 1804, Jacksonville, FL 32207 | 2006-11-07 |
| 1891799136 | Richard Clarke Agnew | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-06-01 |
| 1407858749 | Raymond Lee | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1824 King St Ste 200, Jacksonville, FL 32204-4736 | 2005-06-01 |
| 1386206720 | Jorge Marcelo Sanjines | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 655 W 8th St, Jacksonville, FL 32209-6511 | 2019-07-06 |
| 1285149138 | Baptist Specialty Physicians Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 836 Prudential Dr Ste 807, Jacksonville, FL 32207-8335 | 2017-12-13 |
| 1730699703 | Breah Lynn Paciotti | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2017-10-04 |
| 1932517877 | Magdy El-sayed Ahmed | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2014-07-23 |
| 1992931414 | Samuel Jacob | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2009-06-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.