DR. JULIANNE M WYSOCKI BROADWATER (NPI# 1124255203) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124255203 |
| Entity Type | Individual |
| Full Name | DR. JULIANNE M WYSOCKI BROADWATER |
| Credential | D.O. |
| Practice Address |
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709 |
| Practice Telephone | 3864252285 |
| Practice Fax Number | 3864257522 |
| Mailing Telephone | 3862264590 |
| Mailing Fax Number | 3862264577 |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2020-01-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | OS16421 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
303 N CLYDE MORRIS BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811991227 | Halifax Hospital Medical Center | Case Management | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2005-06-13 |
| 1447860374 | Priscilla Selig | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-08-05 |
| 1770123820 | Jane Hollis | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-01-07 |
| 1619512282 | Kristin Patrice Gardner | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-11-07 |
| 1447804364 | Brenda Martin Cohen | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-29 |
| 1285296574 | Cassie C Norris | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-08 |
| 1063077667 | Jara Apperley | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-05-08 |
| 1972068153 | Sreyboth Sreng | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-02-01 |
| 1356811244 | Matthew Evans | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2018-12-04 |
| 1932679503 | Amanda Gonzalez | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699902874 | Benjamin Michael Mahon | Emergency Medicine | 313 N Clyde Morris Blvd, Daytona Beach, FL 32114 | 2009-06-16 |
| 1740489335 | Abigail Lynn Adams | Emergency Medicine | 1530 Cornerstone Blvd, Suite 200, Daytona Beach, FL 32117-7128 | 2007-07-13 |
| 1760421911 | Lyle Zeke Patterson | Emergency Medicine | 303 N. Clyde Morris Blvd., Halifax Medical Center, Daytona Beach, FL 32114 | 2006-06-05 |
| 1518905207 | Jay C Chanmugam | Emergency Medicine | 303 N Clyde Morris Blvd., Daytona Beach, FL 32114-2709 | 2006-06-03 |
| 1558361428 | Ryan R Rees | Emergency Medicine | 201 N Clyde Morris Blvd Ste 240, Daytona Beach, FL 32114-2765 | 2005-07-21 |
| 1295266773 | Theodore Strom | Emergency Medicine | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2017-03-25 |
| 1619408739 | Abhigyan H Malhotra | Emergency Medicine | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2017-03-21 |
| 1932652849 | Emergency Medicine Professionals Pa | Emergency Medicine | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2016-07-27 |
| 1548617038 | Shelly Birch | Emergency Medicine | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2016-05-16 |
| 1881058881 | Zachary Clyde Terwilliger | Emergency Medicine | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2016-04-06 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on DR. JULIANNE M WYSOCKI BROADWATER.
| 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.