OKALOOSA SURGICAL ASSOCIATES, PA (NPI# 1194810762) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194810762 |
| Entity Type | Organization |
| Organization Name | OKALOOSA SURGICAL ASSOCIATES, PA |
| Practice Address |
550 Twin Cities Blvd Suite C Niceville FL 32578 |
| Practice Telephone | 8506786601 |
| Practice Fax Number | 8506780842 |
| Mailing Telephone | 8506786601 |
| Mailing Fax Number | 8506780842 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2010-09-16 |
| Authorized Official Name | WILLIAM MICHAEL HANEY (PHYSICIAN) |
| Authorized Official Telephone | 8506786601 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 208600000X | Surgery | ME0055821 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 370716400 | 05 | |
| FL | NPI | 1194810762 | 01 |
| Street Address |
550 TWIN CITIES BLVD SUITE C |
| City | NICEVILLE |
| State | FL |
| Zip Code | 32578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568400331 | William Michael Haney | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578 | 2006-06-03 |
| 1790042711 | Genesiscare Usa of Florida LLC | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578-1067 | 2012-04-16 |
| 1760653216 | Robert E Hruby Md, Pa | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578-1067 | 2008-03-12 |
| 1821025008 | Stephen T Enguidanos | Orthopaedic Surgery | 550 Twin Cities Blvd, Niceville, FL 32578-1067 | 2006-06-26 |
| 1144260746 | Harry F Johnson | Physician Assistant | 550 Twin Cities Blvd, Suite A, Niceville, FL 32578-1067 | 2006-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376028563 | Southern Breeze Healthcare | Family Medicine | 4556 E Hwy 20, Suite 105, Niceville, FL 32578 | 2018-10-03 |
| 1497252860 | Molly Marie Everitt | Physician Assistant | 2190 Fl-85 N, Niceville, FL 32578 | 2018-04-11 |
| 1972009314 | Alexis Aust | Student in an Organized Health Care Education/Training Program | 104 Arrowhead Way, Niceville, FL 32578 | 2018-04-04 |
| 1518488949 | Michelle Sasala | Nurse Practitioner | 4550 E Highway 20, Niceville, FL 32578 | 2017-07-06 |
| 1003336199 | Comfortable Care Denta Health Professionals, Pa | Dentist | 1386 E John Sims Parkway, Niceville, FL 32578 | 2017-06-21 |
| 1306223888 | Emerald Coast Periodontics | Dentist | 719 Bayshore Drive, Niceville, FL 32578 | 2015-05-04 |
| 1538586136 | Pamela Ottesen Dmd LLC | Dentist | 1536 John Sims Pkwy, Niceville, FL 32578 | 2014-03-21 |
| 1417204066 | Mary Jo Stiles | Hearing Instrument Specialist | 4400 Hwy, 20 East, Suite # 211, Niceville, FL 32578 | 2012-08-13 |
| 1093086563 | Pat T. Tidwell Md Pa | Clinic/Center | 4554 Highway 20 East, Niceville, FL 32578 | 2012-01-16 |
| 1952683260 | Gentle Birth Options, LLC | Nurse Practitioner | 296 Bayshore Drive, Niceville, FL 32578 | 2011-09-13 |
| Find all providers in zip 32578 | ||||
| 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 |
|---|---|---|---|---|
| 1336509546 | Genesiscare Usa of Florida LLC | Surgery | 550 Twin Cities Blvd Ste C, Niceville, FL 32578-1050 | 2016-03-01 |
| 1679513410 | Robert E. Hruby | Surgery | 550 Twin Cities Blvd., Suite C, Niceville, FL 32578 | 2006-06-08 |
| 1568400331 | William Michael Haney | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578 | 2006-06-03 |
| 1326013822 | Sushil Kumar Asthana | Surgery | 1005 College Blvd W, Suite C, Niceville, FL 32578-1053 | 2006-02-20 |
| 1790042711 | Genesiscare Usa of Florida LLC | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578-1067 | 2012-04-16 |
| 1760653216 | Robert E Hruby Md, Pa | Surgery | 550 Twin Cities Blvd, Suite C, Niceville, FL 32578-1067 | 2008-03-12 |
| 1316017775 | Niceville General Surgery LLC | Surgery | 1001 College Blvd W, Suite B-1, Niceville, FL 32578-1099 | 2006-11-09 |
| 1013944552 | Hygeia Medical Group Pa | Surgery | 1005 College Blvd W, Suite C, Niceville, FL 32578-1053 | 2006-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301263 | Heather Marie Gable | Surgery | 6150 Diamond Centre Ct # 1300, Fort Myers, FL 33912-4367 | 2020-09-21 |
| 1932713476 | Gabriel Nicolas Chapman | Surgery | 12301 Trout Cir, Spring Hill, FL 34609-4962 | 2020-09-02 |
| 1396356960 | After Hours Surgical Care LLC | Surgery | 11766 Foxbriar Lake Trl, Boynton Beach, FL 33473-7830 | 2020-08-16 |
| 1588288203 | Samuel Joseph | Surgery | 22730 Sw 55th Ave, Boca Raton, FL 33433-6258 | 2020-05-29 |
| 1720601768 | Ked Medical, P.a. | Surgery | 3001 N Rocky Point Dr E Ste 100, Tampa, FL 33607-5860 | 2020-05-26 |
| 1952922270 | Glenn Edmund Bryan Jr. | Surgery | 4255 N Us Highway 1, Melbourne, FL 32935-4822 | 2020-04-27 |
| 1821618729 | Herbert Paul Lerner | Surgery | 10815 Royal Devon Way, Lake Worth, FL 33449-8650 | 2020-04-21 |
| 1003441981 | Comprehensive Care Partners | Surgery | 3101 University Blvd S Ste 100, Jacksonville, FL 32216-2750 | 2020-03-11 |
| 1831749977 | Imed Surgical of Miami, Pa | Surgery | 175 Sw 7th St Ste 1710, Miami, FL 33130-2957 | 2019-09-19 |
| 1174170914 | Vip Surgeries | Surgery | 1301 E Broward Blvd Ste 220, Fort Lauderdale, FL 33301-2111 | 2019-08-26 |
| 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.