STEWARD MEDICAL GROUP, INC. (NPI# 1104367630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104367630 |
| Entity Type | Organization |
| Organization Name | STEWARD MEDICAL GROUP, INC. |
| Practice Address |
1317 W Point Dr Cocoa FL 32922-6464 |
| Mailing Address |
9 Galen St Watertown MA 02472-4515 |
| Practice Telephone | 6154674158 |
| Practice Fax Number | 6154671267 |
| Mailing Telephone | 6175625359 |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2020-08-13 |
| Authorized Official Name | ASHLEY KOCH (CFO) |
| Authorized Official Telephone | 6175625359 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548701857 | Steward Medical Group, Inc. | Counselor | 77 Warren St, Brighton, MA 02135-3601 | 2017-03-20 |
| 1073826111 | Steward Medical Group, Inc. | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| 1982917027 | Steward Medical Group, Inc. | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| 1437462587 | Steward Medical Group, Inc. | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| 1801109947 | Steward Medical Group, Inc. | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| 1265745301 | Steward Medical Group, Inc. | Specialist | 77 Warren St, Brighton, MA 02135-3601 | 2010-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | STEWARD MEDICAL GROUP, INC. | 28 Liberty St., New York, Ny 10005 |
| Massachusetts Corporations | STEWARD MEDICAL GROUP, INC. | 500 Boylston St., Boston, MA 02116 |
| Street Address |
1317 W POINT DR |
| City | COCOA |
| State | FL |
| Zip Code | 32922-6464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164495305 | Hany Sobhy Guirguis | Internal Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2006-02-08 |
| 1184954109 | Family Medical Care of Brevard P.a. | Internal Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2010-01-14 |
| 1841392339 | West Point Medical Group | Family Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2006-09-04 |
| 1245203975 | Mark K Pinkowski | Family Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2006-02-13 |
| 1437122165 | Alessandro L Acosta-fajardo | Family Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2006-02-13 |
| 1124091228 | Raymond C Baez | Internal Medicine | 1317 W Point Dr, Cocoa, FL 32922-6464 | 2006-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396260030 | Shacarra Danielle Pouncey | Behavioral Analyst | 453 King Street, Cocoa, FL 32922 | 2017-08-03 |
| 1851815849 | El-shaddai & Sons Maintenance LLC | Non-emergency Medical Transport (VAN) | 209 Factory St, Cocoa, FL 32922 | 2017-08-01 |
| 1891241949 | Stephanie B Duncan Kidwell | Developmental Therapist | 453 Cocoa St., Cocoa, FL 32922 | 2016-08-29 |
| 1861859746 | Ruth Ellis | Counselor | 7 N. Cocoa Blvd., Cocoa, FL 32922 | 2016-01-22 |
| 1528334109 | Cynthia Vicky Doyle | Counselor | 1407 Dixon Blvd., Cocoa, FL 32922 | 2012-03-28 |
| 1205156106 | Rhea Lucette Gibbs | Social Worker | 317 Riveredge B Lvd., Suite 104, Cocoa, FL 32922 | 2010-06-03 |
| 1871816439 | Suzanne P. Jasper-demarco | Behavioral Analyst | 550 Saint Johns St, Cocoa, FL 32922 | 2010-03-10 |
| 1023223294 | Loraine Catalano Schuh | Social Worker | 317 Riveredge Blvd, Suite 104, Cocoa, FL 32922 | 2007-05-11 |
| 1679795546 | Amber Elizabeth Bell | Counselor | Kidspeace, 633-b Brevard Avenue, Cocoa, FL 32922 | 2007-05-02 |
| 1154549343 | Venkata Naga Laxmi Cheedhella | Pharmacist | 1451 Dixon Blvd, Cocoa, FL 32922 | 2007-04-23 |
| Find all providers in zip 32922 | ||||
| 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 |
|---|---|---|---|---|
| 1225357973 | Mourad Abouelleil | Urology | 7227 N Us Highway 1, Suite 220, Cocoa, FL 32927-5020 | 2010-05-20 |
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| 1710442264 | Urologic Specialists of Central Florida Pllc | Urology | 575 S Wickham Rd Ste A, West Melbourne, FL 32904-1170 | 2019-02-08 |
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| 1366916843 | Dr. Carolyn Langford Urologic Solutions, LLC | Urology | 9400 Gladiolus Dr Ste 30, Fort Myers, FL 33908-9615 | 2019-01-17 |
| 1376016568 | Advanced Innovative Urology Pa | Urology | 4737 N Ocean Dr Ste 103, Lauderdale By The Sea, FL 33308-2920 | 2019-01-10 |
| 1306314281 | Urology Consultants of Boca Raton Pa | Urology | 825 Meadows Rd Ste 111, Boca Raton, FL 33486-2347 | 2018-11-08 |
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| Find all providers with the same taxonomy | ||||
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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.