SURYA P RAO (NPI# 1114975596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114975596 |
| Entity Type | Individual |
| Full Name | SURYA P RAO |
| Credential | MD |
| Practice Address |
1404 S Ridgewood Ave Edgewater FL 32132-2720 |
| Mailing Address |
695 N Clyde Morris Blvd Daytona Beach FL 32114-2321 |
| Practice Telephone | 3862588722 |
| Practice Fax Number | 3862655928 |
| Mailing Telephone | 3862588722 |
| Mailing Fax Number | 3862589443 |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2020-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
ME96830 | FL | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
ME96830 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BC/BS | 94219 | 01 |
| FL | 281152900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 780 Dunlawton Ave Ste 101, Port Orange, FL 321274252 | 3862655926 | 3862655928 |
| Street Address |
1404 S RIDGEWOOD AVE |
| City | EDGEWATER |
| State | FL |
| Zip Code | 32132-2720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205824778 | Margaret Chang | Family Medicine | 1404 S Ridgewood Ave, Edgewater, FL 32132-2720 | 2005-10-10 |
| 1962579086 | Shelly Lynn Fradet | Physician Assistant | 1404 S Ridgewood Ave, Edgewater, FL 32132-2720 | 2006-11-30 |
| 1275552358 | Coastal Family Practice LLC | Family Medicine | 1404 S Ridgewood Ave, Edgewater, FL 32132-2720 | 2006-07-19 |
| 1275521759 | Patricia Fredette-huffman | Family Medicine | 1404 S Ridgewood Ave, Edgewater, FL 32132-2720 | 2005-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124389663 | Jeannine Parisi | Technician | 1610 Royal Palm Dr, Edgewater, FL 32132 | 2012-05-31 |
| 1992071575 | Mary E. Curtiss | Dietitian, Registered | 104 W. Knapp Ave, Edgewater, FL 32132 | 2012-03-28 |
| 1285923284 | Bhi of Central Florida Corporation | Non-emergency Medical Transport (VAN) | 1869 India Palm Dr, Edgewater, FL 32132 | 2011-03-31 |
| 1649440728 | Advanced Care Agency Inc. | Nurse's Aide | 212 Shangri La Circle, Edgewater, FL 32132 | 2008-03-05 |
| 1962544031 | Mary Daine Swindle | Nurse's Aide | 212 Shangri La Cr, Edgewater, FL 32132 | 2007-02-13 |
| 1003957465 | Alan Leonard Horowitz | Chiropractor | 612 N Ridgewood Ave, Suite I, Edgewater, FL 32132 | 2007-02-09 |
| 1255415550 | Professional Physical Therapy and Associates Ltd Co | Physical Therapist | 1316 S. Ridgewood Avenue, Suite 1, Edgewater, FL 32132 | 2006-10-24 |
| 1205919362 | David Storm Chess | Chiropractor | 930 S Ridgewood Ave, Edgewater, FL 32132 | 2006-10-23 |
| 1235231242 | Roger Prieto | Dentist | 1401 S Ridgewood Ave, Edgewater, FL 32132 | 2006-09-01 |
| 1497861306 | Crystal R Mead | Physician Assistant | 109 W Knapp Avenue, Edgewater, FL 32132 | 2006-08-22 |
| Find all providers in zip 32132 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194269639 | John Shao Md LLC | Internal Medicine | 718 Hudson Park, Edgewater, NJ 07020-1498 | 2016-12-16 |
| 1649610965 | David Fridman | Internal Medicine | 1077 River Rd Apt 504, Edgewater, NJ 07020-1354 | 2013-07-01 |
| 1043228588 | Irfan Admani | Internal Medicine | 103 River Road, Edgewater, NJ 07020 | 2006-08-03 |
| 1821082827 | Radu Codel | Internal Medicine | 968 River Rd, Edgewater, NJ 07020-1221 | 2005-09-06 |
| 1376548719 | Yaron Bareket | Internal Medicine | 103 River Rd, Edgewater, NJ 07020-1010 | 2005-06-14 |
| 1710408596 | Icahn School of Medicine At Mount Sinai | Internal Medicine | 103 River Rd Fl 2, Edgewater, NJ 07020-1016 | 2017-06-30 |
| 1598048233 | Ccc Vein Care LLC | Internal Medicine | 103 River Rd, Suite202, Edgewater, NJ 07020-1016 | 2011-09-20 |
| 1316139983 | Radu Codel Md PC | Internal Medicine | 968 River Rd, Edgewater, NJ 07020-1221 | 2007-08-16 |
| 1538164975 | Rick Pumill | Internal Medicine | 103 River Rd, Edgewater, NJ 07020-1010 | 2005-06-14 |
| 1073518411 | Fernando Segovia | Internal Medicine | 103 River Rd, Edgewater, NJ 07020-1010 | 2005-06-14 |
| Find all providers in EDGEWATER | ||||
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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.