CARRILLO SURGICAL ASSOCIATES LLC (NPI# 1104871102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104871102 |
| Entity Type | Organization |
| Organization Name | CARRILLO SURGICAL ASSOCIATES LLC |
| Practice Address |
1311 Garden St Titusville FL 32796-3312 |
| Practice Telephone | 3212680720 |
| Practice Fax Number | 3213837596 |
| Mailing Telephone | 3212680720 |
| Mailing Fax Number | 3213837596 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2014-08-18 |
| Authorized Official Name | TINA CARRILLO (R.N.) |
| Authorized Official Telephone | 3212680720 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| Street Address |
1311 GARDEN ST |
| City | TITUSVILLE |
| State | FL |
| Zip Code | 32796-3312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114226362 | Christine Rene Carrillo | Registered Nurse | 1311 Garden St, Titusville, FL 32796-3312 | 2011-03-26 |
| 1104043108 | Onofre P. Carrillo | Family Medicine | 1311 Garden St, Titusville, FL 32796-3312 | 2007-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427698091 | Miranda Jade Lacey | Behavior Technician | 2073 Graden St, Titusville, FL 32796 | 2020-01-13 |
| 1588183818 | Charles Hopkins Jr. | Behavior Technician | 2073 Garden St., Titusville, FL 32796 | 2017-09-19 |
| 1962924456 | Robin Marie Ahlgren | Social Worker | 503 South Palm Ave, Titusville, FL 32796 | 2017-07-17 |
| 1669994158 | New Creation Counseling | Social Worker | 503 South Palm Ave., Titusville, FL 32796 | 2017-07-17 |
| 1255719506 | Daniel Joseph Spagnoli | Dentist | 55 N Carpenter Rd, Titusville, FL 32796 | 2015-05-07 |
| 1033511415 | Imran Rashid Md Pa | Internal Medicine | 3300 Dairy Road, Titusville, FL 32796 | 2014-09-17 |
| 1639425432 | William Henry Ruppert Jr. | Dietitian, Registered | 2191 Garden Street, Titusville, FL 32796 | 2012-07-30 |
| 1437410230 | Betsy Cooduvalli | Dermatology | 500 N Washington Ave Ste 109, Titusville, FL 32796 | 2012-06-07 |
| 1134403108 | Titusville Chiropractic & Injury Center, Inc. | Chiropractor | 850 Century Medical Drive, Titusville, FL 32796 | 2011-10-07 |
| 1992095152 | Jennifer Eleanor Koffman | Occupational Therapy Assistant | 140 N Hilltop Drive, Titusville, FL 32796 | 2011-04-08 |
| Find all providers in zip 32796 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043405509 | John Francis Kustrup Jr. | Surgery | 9 River Knoll Drive, Titusville, NJ 08650-1305 | 2007-09-07 |
| 1609987015 | Catherine A Fonash | Surgery | 150 W Central Ave, Titusville, PA 16354-1724 | 2006-08-31 |
| 1699724369 | Rameshbhai P Patel | Surgery | 494 North Washington Avenue, Suite 2, Titusville, FL 32796 | 2006-05-09 |
| 1770996308 | Saint Vincent Medical Education and Research Institute | Surgery | 150 W Central Ave, Suite 3, Titusville, PA 16354-1724 | 2014-06-11 |
| 1780871830 | Titusville Surgical Associates Md Pa | Surgery | 494 North Washington Avenue, Suite #2, Titusville, FL 32781 | 2007-10-02 |
| 1750508446 | John Zambos | Surgery | 605 N Washington Ave, Suite 200, Titusville, FL 32796-2107 | 2007-04-20 |
| 1548310543 | Dwain M. Rogers | Surgery | 406 W Oak St, Titusville, PA 16354-1404 | 2007-01-11 |
| 1679641708 | Pedram Zendehrouh | Surgery | 951 N Washington Ave, Parrish Wound Healing Center, Titusville, FL 32796-2163 | 2006-11-30 |
| 1346349099 | Ralph E Nazzaro | Surgery | 150 W Central Ave, Titusville, PA 16354-1724 | 2006-09-21 |
| 1134165699 | Anil Kumar Dutt | Surgery | 406 W Oak St, Titusville, PA 16354-1404 | 2006-06-22 |
| Find all providers in TITUSVILLE | ||||
| City | TITUSVILLE |
| Zip Code | 32796 |
Please comment or provide details below to improve the information on CARRILLO SURGICAL ASSOCIATES LLC.
| 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.