RONALD MARTIN MALL (NPI# 1083648703) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083648703 |
| Entity Type | Individual |
| Full Name | RONALD MARTIN MALL |
| Credential | DO |
| Practice Address |
3800 East Bay Drive East Bay Medical Center Largo FL 33771 |
| Mailing Address |
13020 Park Blvd Oakhurst Medical Clinic Semionle FL 33776 |
| Practice Telephone | 7275390505 |
| Practice Fax Number | 7273941804 |
| Mailing Telephone | 7273933404 |
| Mailing Fax Number | 7273941804 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2011-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | OS0003675 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 2337655 | 01 | |
| AVMED | 267070 | 01 |
| Street Address |
3800 EAST BAY DRIVE EAST BAY MEDICAL CENTER |
| City | LARGO |
| State | FL |
| Zip Code | 33771 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970822 | Keys2health LLC | Nurse Practitioner | 1050 Starkeyrd. Unit 606, Largo, FL 33771 | 2020-07-23 |
| 1194210906 | Agape Gem Care LLC | In Home Supportive Care | 2945 E Bay Dr Ste A, Largo, FL 33771 | 2018-06-25 |
| 1487162723 | Aim Medical Supply, Inc | Durable Medical Equipment & Medical Supplies | 8380 Ulmerton Rd Ste 302, Largo, FL 33771 | 2018-01-22 |
| 1629511720 | Jane Maguire Inc | Counselor | 1101 Belcher Rd. S., Suite J., Largo, FL 33771 | 2016-11-22 |
| 1477890283 | Celisa K Bonner | Social Worker | 13787 Belcher Road S., Suite 220, Largo, FL 33771 | 2013-01-14 |
| 1619283330 | Mary J. Martin | Counselor | 1101 S. Belcher Rd, Suite E, Largo, FL 33771 | 2010-08-19 |
| 1578796538 | Miguel Messina | Counselor | 1501 S. Belcher Rd, Suite B-4, Largo, FL 33771 | 2009-08-25 |
| 1255569943 | Zozan Al Saadi | Family Medicine | 7050 Ulmerton Rd, Largo, FL 33771 | 2009-07-01 |
| 1104060391 | Letitia A Mcintosh-reid | Behavioral Analyst | 940 Starkey Road, # 3105, Largo, FL 33771 | 2009-05-01 |
| 1063665867 | East Bay Family Practice LLC | Family Medicine | 3387 3391 Easy Bay Drive, Largo, FL 33771 | 2008-10-24 |
| Find all providers in zip 33771 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427399203 | Charles Robert Kerr | General Practice | 9664 Halyard Dr, Largo, FL 33773-4421 | 2013-03-04 |
| 1568777548 | Lee Laravia | General Practice | 2025 Indian Rocks Rd, Largo, FL 33774 | 2010-08-13 |
| 1275848426 | Dwic of Tampa Bay, Inc. | General Practice | 10500 Ulmerton Road, Suite 202, Largo, FL 33771-3503 | 2010-08-12 |
| 1902995038 | Donald Allen Collins | General Practice | 3800 E Bay Dr, Largo, FL 33771-1937 | 2006-10-12 |
| 1891143095 | Phillip Robert Braunlich | General Practice | 201 14th St Sw, Largo, FL 33770-3133 | 2016-05-27 |
| 1942684568 | Ryan Alan Schuering | General Practice | 201 14th St Sw, Largo, FL 33770-3133 | 2015-07-14 |
| 1457734493 | Kelly Segars | General Practice | 201 14th St Sw, Largo, FL 33770-3133 | 2015-07-08 |
| 1477930501 | Edel Alvarez Galban | General Practice | 12150 Seminole Blvd, Largo, FL 33778-2833 | 2015-04-27 |
| 1770973224 | Belleair Wellness Center & Spa | General Practice | 2130 W Bay Dr, Largo, FL 33770-1927 | 2015-02-04 |
| 1457769044 | Kamiro Holdings, Inc. | General Practice | 10500 Ulmerton Rd, Suite 360, Largo, FL 33771-3544 | 2014-07-26 |
| Find all providers in LARGO | ||||
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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.