FLORIDA PHYSICIAN SPECIALISTS LLC (NPI# 1083959563) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083959563 |
| Entity Type | Organization |
| Organization Name | FLORIDA PHYSICIAN SPECIALISTS LLC |
| Other Organization Name | KASRAEIAN UROLOGY |
| Practice Address |
6269 Beach Blvd Suite 2 Jacksonville FL 32216-2768 |
| Practice Telephone | 9047277955 |
| Practice Fax Number | 9047277976 |
| Mailing Telephone | 9047277955 |
| Mailing Fax Number | 9047277976 |
| Enumeration Date | 2012-12-10 |
| Last Update Date | 2012-12-10 |
| Authorized Official Name | AHMAD KASRAEIAN (CEO) |
| Authorized Official Telephone | 9047277955 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2088F0040X |
Urology Specialization: Female Pelvic Medicine and Reconstructive Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Kasraeian Urology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033544390 | Florida Physician Specialists LLC | Radiology | 7017 A C Skinner Pkwy, Jacksonville, FL 32256-6932 | 2013-09-05 |
| 1932680469 | Florida Physician Specialists LLC | Non-Pharmacy Dispensing Site | 7017 A C Skinner Pkwy, Jacksonville, FL 32256-6932 | 2018-08-23 |
| 1437495868 | Florida Physician Specialists LLC | Urology | 836 Prudential Drive, Suite 1606, Jacksonville, FL 32207-8343 | 2012-12-12 |
| 1316282478 | Florida Physician Specialists LLC | Urology | 3550 University Blvd S, Suite 202, Jacksonville, FL 32216-4246 | 2012-11-30 |
| 1932444254 | Florida Physician Specialists LLC | Urology | 1715 Village Way, Orange Park, FL 32073-5263 | 2012-11-28 |
| 1619221637 | Florida Physician Specialists LLC | Urology | 710 Lomax St, Jacksonville, FL 32204-4004 | 2012-10-29 |
| 1588917108 | Florida Physician Specialists LLC | Radiology | 710 Lomax St, Suite 1, Jacksonville, FL 32204-4004 | 2012-10-19 |
| Street Address |
6269 BEACH BLVD SUITE 2 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-2768 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659374320 | Ahmad Kasraeian | Urology | 6269 Beach Blvd, Ste 2, Jacksonville, FL 32216-2705 | 2005-05-24 |
| 1992081715 | Medical Partners of Jacksonville LLC | Pain Medicine | 6269 Beach Blvd, Jacksonville, FL 32216-2768 | 2011-10-25 |
| 1649574500 | Integrated Community Oncology Network LLC | Urology | 6269 Beach Blvd, Suite 2, Jacksonville, FL 32216-2768 | 2011-01-06 |
| 1578727442 | Kasraeian Urology LLC | Urology | 6269 Beach Blvd, Suite 2, Jacksonville, FL 32216-2768 | 2008-07-10 |
| 1336213271 | Ali Kasraeian | Urology | 6269 Beach Blvd, Suite 2, Jacksonville, FL 32216-2768 | 2006-11-20 |
| 1134156573 | Donald A. Barnhorst Jr. Md Pa | Eyewear Supplier (Equipment, not the service) | 6269 Beach Blvd, Suite 4, Jacksonville, FL 32216 | 2006-06-28 |
| 1861447138 | Donald Anthony Barnhorst Jr. | Ophthalmology | 6269 Beach Blvd, Suite 4, Jacksonville, FL 32216-2705 | 2006-05-24 |
| 1649265463 | Vaishali B Doolabh | Surgery | 6269 Beach Blvd, Suite 1, Jacksonville, FL 32216-2705 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053859041 | Soroush Bazargani | Urology | 653 W 8th St Lrc Bldg Fl 2, Jacksonville, FL 32216-6511 | 2017-02-09 |
| 1538534409 | Clinical Urology Associates, P.C. | Urology | 820 Pelham Rd S, Jacksonville, AL 36265-2736 | 2015-12-03 |
| 1356692065 | Onslow Ambulatory Services, Inc. | Urology | 52 Office Park Dr, Suite B, Jacksonville, NC 28546-3217 | 2012-09-21 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1275597817 | Thomas L Wilson M D Ltd | Urology | 814 W State, Jacksonville, IL 62650 | 2006-04-12 |
| 1164484267 | Charles Stott Wilson | Urology | 814 West State, Jacksonville, IL 62650 | 2006-04-04 |
| 1912967860 | Fawaz M Ashouri | Urology | 2301 University Blvd W, Jacksonville, FL 32217 | 2006-03-24 |
| 1972578136 | Christopher Ramon Williams | Urology | 8708 Perimeter Park Blvd Ste 4, Jacksonville, FL 32216 | 2006-02-21 |
| 1659374320 | Ahmad Kasraeian | Urology | 6269 Beach Blvd, Ste 2, Jacksonville, FL 32216-2705 | 2005-05-24 |
| 1013542919 | Ackerman Cancer Center, Pa | Urology | 10232 San Jose Blvd, Jacksonville, FL 32257 | 2020-03-11 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.