SOUTHEASTERN INTEGRATED MEDICAL PL (NPI# 1093970162) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093970162 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN INTEGRATED MEDICAL PL |
| Practice Address |
4881 Nw 8th Ave Suite 2 Gainesville FL 32605-4582 |
| Practice Telephone | 3522242486 |
| Practice Fax Number | 3523316550 |
| Mailing Telephone | 3523736338 |
| Mailing Fax Number | 3523736144 |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2008-07-28 |
| Authorized Official Name | MR. JESSE C BRANNEN (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3522242200 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEASTERN INTEGRATED MEDICAL PL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
PY6591 | FL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 058586600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255762928 | Southeastern Integrated Medical Pl | Physical Medicine & Rehabilitation | 3305 Sw 34th Cir, Suite 101, Ocala, FL 34474-6616 | 2013-12-06 |
| 1720419484 | Southeastern Integrated Medical Pl | Physical Medicine & Rehabilitation | 1315 Nw 21st Ave, Suite 2, Chiefland, FL 32626-1977 | 2013-12-06 |
| 1912146853 | Southeastern Integrated Medical Pl | Radiology | 3304 Sw 34th Cir, Ocala, FL 34474-3358 | 2009-02-17 |
| 1871573949 | Southeastern Integrated Medical Pl | Allergy & Immunology | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2006-01-17 |
| Street Address |
4881 NW 8TH AVE SUITE 2 |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32605-4582 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336125848 | Bernard Bryan Bulcourf | Psychologist | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2005-12-16 |
| 1992870380 | John Anthony Bailey | Anesthesiology | 4881 Nw 8th Ave, Ste 2, Gainesville, FL 32605-4582 | 2006-11-21 |
| 1750487872 | Gainesville Urology Center Pa | Urology | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2006-09-16 |
| 1144275918 | Lu Anne Faubion | Nurse Practitioner | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2006-05-23 |
| 1992784284 | Jesse August Lipnick | Pain Medicine | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2006-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780205435 | Remy Fadel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terr, Gainsville, FL 32605 | 2020-05-05 |
| 1518528652 | Family Restoration Station Counseling Center, LLC | Marriage & Family Therapist | 912 Nw 56th Terr, Suite A, Gainesville, FL 32605 | 2019-06-27 |
| 1568925105 | Ryeisha Hough | Behavior Technician | 1051 Sw 56 Terrace, Gainesville, FL 32605 | 2019-04-10 |
| 1003308040 | Titan Mri LLC | Clinic/Center | 919 Nw 57th St Ste 20, Gainesville, FL 32605 | 2018-06-05 |
| 1922598432 | Angela Maria Fernandez Manovel | Student in an Organized Health Care Education/Training Program | 1147 Nw 64th Terrace, Gainesville, FL 32605 | 2018-05-10 |
| 1396235800 | Aya Marachi | Student in an Organized Health Care Education/Training Program | 6500 W. Newberry Rd., Gainesville, FL 32605 | 2018-05-10 |
| 1053813543 | Jaime L Jasser | Counselor | 2240 Nw 40th Terrace Ste A, Gainesville, FL 32605 | 2018-03-01 |
| 1164932901 | Anesthesia Physician Solutions of North Florida, LLC | Anesthesiology | 6500 W Newberry Road, Gainesville, FL 32605 | 2017-10-06 |
| 1336667930 | Zina Theresse Durr | Adult Companion | 3124 Nw 29th Place, Gainesville, FL 32605 | 2017-09-03 |
| 1982126306 | Crystal Thompson Baumann | Nurse Practitioner | 6440 W Newberry Rd Ste 409, Gainesville, FL 32605 | 2017-07-07 |
| Find all providers in zip 32605 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817760 | Appendix, Inc | Counselor | 2228 Nw 44th Pl, Gainesville, FL 32605-1761 | 2020-10-06 |
| 1063019057 | Shaun Michael Anderson | Counselor | 235 S Main St Ste 203, Gainesville, FL 32601-6585 | 2020-10-03 |
| 1538775804 | Daniel Patrick Blakeman | Counselor | 2220 Sw 34th St Apt 326, Gainesville, FL 32608-1213 | 2020-09-21 |
| 1265041487 | Margaret Ann Creegan | Counselor | 8763 Sw 27th Ln, Gainesville, FL 32608-9338 | 2020-07-23 |
| 1073134813 | Sun View Counseling LLC | Counselor | 3550 Nw 87 Ter., Gainesville, FL 32606 | 2020-05-04 |
| 1326669490 | Jennifer Beaujon | Counselor | 6117 Cardinal Dr, Gainesville, GA 30506-2437 | 2020-04-30 |
| 1699303602 | Sunni S Lutton | Counselor | 3745 Sw 3rd Pl, Gainesville, FL 32607-2846 | 2020-03-27 |
| 1275163420 | Yarelis Serrano | Counselor | 8763 Sw 27th Ln # 101, Gainesville, FL 32608-9338 | 2020-01-16 |
| 1861039968 | Lori Lynn Mcgruder | Counselor | 1607 Nw 120th Way, Gainesville, FL 32606-5273 | 2019-12-08 |
| 1003467788 | Darcy Pare | Counselor | 10390 Sw 105th Dr, Gainesville, FL 32608-7358 | 2019-09-24 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 32605 |
Please comment or provide details below to improve the information on SOUTHEASTERN INTEGRATED MEDICAL PL.
| 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.