DR. NATHAN PATRICK WIDBOOM (NPI# 1144565532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144565532 |
| Entity Type | Individual |
| Full Name | DR. NATHAN PATRICK WIDBOOM |
| Credential | D.O. |
| Practice Address |
7031 Sw 62nd Ave South Miami FL 33143-4701 |
| Practice Telephone | 3052847761 |
| Mailing Telephone | 3052847761 |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2020-02-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | OS13591 | FL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | OS13591 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
7031 SW 62ND AVE |
| City | SOUTH MIAMI |
| State | FL |
| Zip Code | 33143-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649251083 | Juan Carlos Cucalon | Anesthesiology | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2005-11-11 |
| 1851904601 | Mobashir Hosameddin | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-30 |
| 1013529304 | Samuel Damain Pepeto Clarke | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-19 |
| 1013529379 | Jose Carlos Cabrera Saavedra | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-18 |
| 1477164077 | Patrick Mercho | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-17 |
| 1003427675 | Matthew Aziz Faheim Hanna | Family Medicine | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-16 |
| 1730790452 | Aadil Modi | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-14 |
| 1518578202 | Michael Anthony Wilson | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-14 |
| 1437760949 | Jeremy Eckes | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-08-10 |
| 1912524208 | Hobert Rivero Zamora | Student in an Organized Health Care Education/Training Program | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2020-07-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821610395 | Klsirage LLC | Dentist | 8688 Sw 72 St, Miami, FL 33143 | 2020-05-07 |
| 1417577669 | Ahc Diagnostic and Imaging Services | Clinic/Center | 8000 Sw 67th Avenue, Miami, FL 33143 | 2020-04-17 |
| 1841832359 | Haytham Elgammal | Internal Medicine | 7031 Sw 62nd, Miami, FL 33143 | 2019-10-16 |
| 1326504077 | Zavita Life Health & Wellness | Clinic/Center | 6104 S Dixie Hwy, Miami, FL 33143 | 2019-02-19 |
| 1629548706 | Floridacare Medical Centers Inc | Internal Medicine | 434 Sw 12 Ave, Miami, FL 33143 | 2018-11-30 |
| 1649766197 | Demys D Gonzalez | Nurse Practitioner | 6705 Sw 57th Ave Ste 522, South Miami, FL 33143 | 2018-07-09 |
| 1225529373 | Marjory P Camargo Bermejo | Behavior Technician | 7368sw 80 Street Plaza Apto 168, Mi, Miami, FL 33143 | 2018-05-24 |
| 1609365147 | Foot Ankle and Knee Mri LLC | Clinic/Center | 7520 Sw 57th Ave Ste A, South Miami, FL 33143 | 2018-05-09 |
| 1871082024 | Healing Counseling Services, LLC | Counselor | 8100 Sw 81st Street Drive, Suite 276, Miami, FL 33143 | 2018-05-03 |
| 1750882957 | Aba Therapy & Instruction Corp | Behavioral Analyst | 8101 Camino Real Apt C-204, Miami, FL 33143 | 2018-02-22 |
| Find all providers in zip 33143 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841659786 | Jesse Kemmerlin | Neuromusculoskeletal Medicine & OMM | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2016-02-21 |
| 1902236680 | David Stuckey | Neuromusculoskeletal Medicine & OMM | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2013-11-18 |
| 1194060756 | Patrick Eugene Barry | Neuromusculoskeletal Medicine & OMM | 7031 Sw 62nd Ave, South Miami, FL 33143-4701 | 2012-12-06 |
| 1780640425 | Ray Lopez | Neuromusculoskeletal Medicine & OMM | 6200 Sunset Dr, Suite 305, South Miami, FL 33143-4828 | 2006-04-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618503 | Pcn Health and Wellness, LLC | Neuromusculoskeletal Medicine & OMM | 2627 Ne 203rd St Ste 100a, Miami, FL 33180-1945 | 2020-08-07 |
| 1316412836 | Osteopathic Medical Arts Center of South Florida LLC | Neuromusculoskeletal Medicine & OMM | 3700 Washington St Ste 401, Hollywood, FL 33021-8249 | 2018-10-11 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1366974800 | Derek Christopher Murphy | Neuromusculoskeletal Medicine & OMM | 110 Alafaya Woods Blvd Ste C-2, Oviedo, FL 32765-4000 | 2017-04-03 |
| 1639538143 | Amy Joy Selwach | Neuromusculoskeletal Medicine & OMM | 870 N Cocoa Blvd Ste A, Cocoa, FL 32922-7588 | 2016-02-12 |
| 1053611251 | Roger R. Verno, D.c.p.a. | Neuromusculoskeletal Medicine & OMM | 2620 N Australian Ave Ste 100, West Palm Beach, FL 33407-5626 | 2010-10-22 |
| 1427374354 | Nabeel Kouka | Neuromusculoskeletal Medicine & OMM | 2999 Ne 191st St Ste 260, Aventura, FL 33180-4925 | 2010-04-16 |
| 1104059005 | New Directions of Central Florida, LLC | Neuromusculoskeletal Medicine & OMM | 9425 Se Highway 42, Summerfield, FL 34491-6405 | 2009-08-26 |
| 1134357957 | Ramon G Lugo-sanchez | Neuromusculoskeletal Medicine & OMM | 2724 Sw 120th Ter, Miramar, FL 33025-0762 | 2009-07-01 |
| 1376702183 | Erik Michael Schabert | Neuromusculoskeletal Medicine & OMM | 4408 Nw 36th Ave, Gainesville, FL 32606-7215 | 2008-06-06 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH MIAMI |
| Zip Code | 33143 |
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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.