FIRST COAST CARDIOVASCULAR (NPI# 1083155725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083155725 |
| Entity Type | Organization |
| Organization Name | FIRST COAST CARDIOVASCULAR |
| Practice Address |
3890 Dunn Ave Ste 203 Jacksonville FL 32218-6428 |
| Mailing Address |
Po Box 551308 Jacksonville FL 32255-1308 |
| Practice Telephone | 9044933333 |
| Practice Fax Number | 9044932222 |
| Mailing Telephone | 9044933333 |
| Mailing Fax Number | 9044932222 |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | DR. YAZAN KHATIB (PRESIDENT) |
| Authorized Official Telephone | 9044933333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467986737 | First Coast Cardiovascular | Internal Medicine | 725 S 6th St, Macclenny, FL 32063-9653 | 2017-04-13 |
| 1265973911 | First Coast Cardiovascular | Internal Medicine | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2017-03-14 |
| 1790226447 | First Coast Cardiovascular | Internal Medicine | 5233 Ricker Rd, Suite 101, Jacksonville, FL 32210-1438 | 2017-03-14 |
| 1811438559 | First Coast Cardiovascular | Internal Medicine | 9759 San Jose Blvd, Ste 2, Jacksonville, FL 32257-4401 | 2017-03-14 |
| 1659812394 | First Coast Cardiovascular | Internal Medicine | 665 State Road 207, Suite 102, St Augustine, FL 32084-5938 | 2017-03-14 |
| 1255872982 | First Coast Cardiovascular | Internal Medicine | 1681 Eagle Harbor Pkwy, Ste B, Fleming Island, FL 32003-4819 | 2017-03-14 |
| 1154862803 | First Coast Cardiovascular | Internal Medicine | 1201 Monument Rd, Suite 201b, Jacksonville, FL 32225-7411 | 2017-03-14 |
| Street Address |
3890 DUNN AVE STE 203 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32218-6428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174595318 | Tina Nannette Tillis | Ophthalmology | 3890 Dunn Ave, #902, Jacksonville, FL 32218-6428 | 2006-02-02 |
| 1740631738 | Terra Harold Jackson | Social Worker | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218-6428 | 2016-06-30 |
| 1467867168 | Tntmd Pa | Ophthalmology | 3890 Dunn Ave, Suite 902, Jacksonville, FL 32218-6428 | 2014-06-23 |
| 1639507254 | John Warren | Counselor | 3890 Dunn Ave, Jacksonville, FL 32218-6428 | 2013-10-16 |
| 1063847465 | Psi Behavioral Health LLC | Case Management | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218-6428 | 2013-09-05 |
| 1124460738 | Psi Family Services | Community/Behavioral Health | 3890 Dunn Ave, Suite 1104, Jacksonville, FL 32218 | 2013-07-24 |
| 1154762284 | Psi Behavioral Health, LLC | Clinic/Center | 3890 Dunn Ave, Sutie 1104, Jacksonville, FL 32218-6428 | 2013-07-17 |
| 1326394792 | Veronica Thompson | Social Worker | 3890 Dunn Ave, Ste. 1104, Jacksonville, FL 32218-6428 | 2012-08-03 |
| 1922361732 | Psi Family Services, Inc. | Preferred Provider Organization | 3890 Dunn Ave, 1104, Jacksonville, FL 32218-6428 | 2012-06-18 |
| 1205105939 | Foot & Ankle Specialists of Jacksonville, Inc. | Podiatrist | 3890 Dunn Ave, Ste 101, Jacksonville, FL 32218-6428 | 2011-12-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684170 | Damon Lamar Baker | Nurse Practitioner | 12533 Sampson Rd, Jacksonville, Fl, FL 32218 | 2020-09-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1932679594 | Alaina Rachelle Stanley | Counselor | 11683 Spring Board Dr, Jacksonville, FL 32218 | 2018-11-27 |
| 1508345133 | War Cry Ministry Inc | Counselor | 435 Eric Ave, Jacksonville, FL 32218 | 2018-08-14 |
| 1285111484 | St Vincent's Full Service Urgent Care, LLC | Clinic/Center | 15510 Max Leggett Parkway, Ste A, Jacksonville, FL 32218 | 2018-07-20 |
| 1427544501 | Derrick Roberts | Behavioral Analyst | 11302 Forestdale Rd, Jacksonville, FL 32218 | 2018-07-02 |
| 1215420229 | Companion & Compassion LLC | Home Health | 856 Poydras Ln W, Jacksonville, FL 32218 | 2018-06-13 |
| 1952894784 | Michael Alexander Aaro | Dentist | 1840 Dunn Ave Ste 3, Jacksonville, FL 32218 | 2018-06-06 |
| 1235629445 | Melissa C Moree | Counselor | 13453 Main St. North, Suite 104, Jacksonville, FL 32218 | 2018-05-14 |
| 1861900896 | Sheila Nowlin | Physical Therapist | 1034 Dunn Ave, Jacksonville, FL 32218 | 2018-01-11 |
| Find all providers in zip 32218 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598182552 | Maedeh Ganji | Internal Medicine | 653 W 8th St # L-18, Jacksonville, FL 32209-6511 | 2014-03-27 |
| 1649696691 | Carolinaeast Physicians | Internal Medicine | 4725 Western Blvd, Jacksonville, NC 28546-6852 | 2014-03-14 |
| 1093151888 | Alejandro Pena Jr. | Internal Medicine | 14546 Old St Augustine Rd Suite 201, Jacksonville, FL 32258-2612 | 2013-05-20 |
| 1669696407 | Ruple Jayantilal Galani | Internal Medicine | 14546 Old Saint Augustine Rd Ste 103, Credentialing Department, Jacksonville, FL 32258-5469 | 2007-04-12 |
| 1154408656 | Heart Clinic of Jacksonville, LLC | Internal Medicine | 9551 Baymeadows Rd Ste 6, Jacksonville, FL 32256-7938 | 2006-11-01 |
| 1487757092 | Cardiovascular Associates of Jacksonville Pa | Internal Medicine | 3599 University Blvd South, Suite 913, Jacksonville, FL 32216-4269 | 2006-09-07 |
| 1316958838 | Valerie Mcnee | Internal Medicine | 1 Red Fox Ln, Jacksonville, AR 72076-2513 | 2006-08-10 |
| 1306895438 | Diagnostic Cardiology Pa | Internal Medicine | 6867 South Point Drive N, Suite 111, Jacksonville, FL 32216-8005 | 2006-05-08 |
| 1790743854 | Baptist Cardiology, Inc. | Internal Medicine | 1905 Corporate Square Blvd, Jacksonville, FL 32216-1940 | 2006-05-01 |
| 1386601896 | James C Campbell | Internal Medicine | 3225 University Blvd S Ste 104, Credentialing Department, Jacksonville, FL 32216-2757 | 2006-04-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32218 |
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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.