LONGWOOD FAMILY MEDICINE PA (NPI# 1073529442) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073529442 |
| Entity Type | Organization |
| Organization Name | LONGWOOD FAMILY MEDICINE PA |
| Practice Address |
515 W State Road 434 Suite 301 Longwood FL 32750-4981 |
| Practice Telephone | 4077860004 |
| Mailing Telephone | 4077860004 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2011-08-26 |
| Authorized Official Name | DR. VIRGIL L DAWSON JR. (PRESIDENT) |
| Authorized Official Telephone | 4077860004 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
515 W STATE ROAD 434 SUITE 301 |
| City | LONGWOOD |
| State | FL |
| Zip Code | 32750-4981 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295734309 | Olen A Giles | Specialist | 515 W State Road 434, Suite 110a, Longwood, FL 32750-4981 | 2005-07-20 |
| 1326452822 | Advanced Analgesia and Anesthesia, Inc | Pain Medicine | 515 W State Road 434, Suite 110, Longwood, FL 32750-4981 | 2014-06-12 |
| 1669812269 | Neel Vipin Patel | Psychiatry & Neurology | 515 W State Road 434, Longwood, FL 32750-4981 | 2013-06-27 |
| 1750729240 | Roshan K Patel | Family Medicine | 515 W State Road 434, Suite 110, Longwood, FL 32750-4981 | 2013-06-06 |
| 1144528522 | Michael Lee Sampson | Physician Assistant | 515 W State Road 434, Ste 203, Longwood, FL 32750-5162 | 2011-03-08 |
| 1639496565 | Ashley R Vrecenak | Physician Assistant | 515 W State Road 434, Suite 210, Longwood, FL 32750-4981 | 2010-05-03 |
| 1457586547 | Kathleen B Zendell | Dermatology | 515 W State Road 434, Suite 210, Longwood, FL 32750-4981 | 2009-05-19 |
| 1275710758 | Kemka S Ogburia Jr. | Specialist | 515 W State Road 434, Suite 210, Longwood, FL 32750-4981 | 2008-01-27 |
| 1609064195 | Urology Consultants | Specialist | 515 W State Road 434, 302, Longwood, FL 32750-4981 | 2007-10-09 |
| 1063608248 | Susan Toth D.o.p.a. | Family Medicine | 515 W State Road 434, Suite 308, Longwood, FL 32750-4981 | 2007-09-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902420920 | Prn Speech Pathologists | Speech-Language Pathologist | 1704 N. Ronald Reagan Blvd, Longwood, FL 32750 | 2020-06-05 |
| 1831743368 | Shamar Anthony Marston | Nurse Anesthetist, Certified Registered | 555 W Fl - 434, Longwood, FL 32750 | 2019-08-01 |
| 1538639125 | Omega Healthcare Solutions, LLC | Case Management | 160 W. Evergreen Avenue Suite 290, Longwood, FL 32750 | 2018-11-27 |
| 1013416080 | Samantha Jane Roberts | Specialist/Technologist, Other | 163 W Bay Ave, Longwood, FL 32750 | 2018-02-06 |
| 1508375874 | Cassandra Thompson-bailey | Nurse Practitioner | 600 N Us Hwy 17 92, Suite 124, Longwood, FL 32750 | 2017-09-29 |
| 1740799535 | Cornerstone Longwood Leasing, LLC | Assisted Living Facility | 480 E. Church Ave., Longwood, FL 32750 | 2017-09-25 |
| 1659890523 | Melissa Shoshana Vigerito | Marriage & Family Therapist | 978 Douglas Ave. Suite 100, Altamonte Springs, FL 32750 | 2017-09-12 |
| 1619498185 | Calm Relief, LLC | Massage Therapist | 1855 W State Road 434, Ste 253, Longwood, FL 32750 | 2017-07-05 |
| 1497145148 | Caitlin Rhea Hilligas | Counselor | 300 N Ronald Reagan Blvd Ste 302, Longwood, FL 32750 | 2015-02-03 |
| 1316344054 | James David Rawlins Jr. | Dentist | 1250 W.s.r 434 Ste. 1008, Longwood, FL 32750 | 2014-11-24 |
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| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649568320 | Linda Marie Matteoli | Family Medicine | 900 Fox Valley Dr Ste 104, Longwood, FL 32779-2551 | 2011-07-15 |
| 1275705717 | Quratulann Iftikhar | Family Medicine | 320 West Sabal Palm Place, Sute 200, Longwood, FL 32779 | 2008-03-25 |
| 1396955837 | Himalatha Venkata Varma | Family Medicine | 556 Fl Central Pkwy, Suite 1024, Longwood, FL 32750-5174 | 2007-05-23 |
| 1346318607 | Simone Uwan | Family Medicine | 587 E State Road 434 Unit 1071, Longwood, FL 32750-5283 | 2006-12-02 |
| 1295824431 | Charles L Batson Pa-family | Family Medicine | 450 W Sr 434, #2010, Longwood, FL 32750-5187 | 2006-10-12 |
| 1013920305 | Carol Andrea Stewart | Family Medicine | 260 Wekiva Springs Rd Ste 100, Longwood, FL 32779-5947 | 2006-08-15 |
| 1316966708 | Ivette Santiago-martir | Family Medicine | 320 W Sabal Palm Pl Ste 200, Longwood, FL 32779-3621 | 2006-07-18 |
| 1396774469 | Vandana Balakrishna Rao | Family Medicine | 855 South U.S. Highway 17-92, Longwood, FL 32750 | 2006-07-01 |
| 1801823281 | Vance J Maloney IIi | Family Medicine | 540 Sabal Lake Dr Apt 106, Longwood, FL 32779-6285 | 2006-06-28 |
| 1194772327 | Associated Family Medicine, Pa | Family Medicine | 320 W Sabal Palm Pl, Suite 200, Longwood, FL 32779-3639 | 2006-05-31 |
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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.