DR. JASON JEONG HWAN SONG (NPI# 1205074002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205074002 |
| Entity Type | Individual |
| Full Name | DR. JASON JEONG HWAN SONG |
| Credential | M.D., PH.D |
| Practice Address |
2801 17th St Unit 202 Saint Cloud FL 34769-4939 |
| Practice Telephone | 4079061328 |
| Practice Fax Number | 8664258143 |
| Mailing Telephone | 4079061328 |
| Mailing Fax Number | 8664258143 |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2020-09-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
ME123792 | FL | Allopathic & Osteopathic Physicians |
| N | 208VP0000X |
Pain Medicine Specialization: Pain Medicine |
123792 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 236756 | MA | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 015031800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538610142 | Jason Song | Dentist | 1628 Hostetter Rd Ste J, San Jose, CA 95131-3309 | 2016-10-18 |
| 1376988782 | Jason Song | Radiology | 450 Stanyan St, San Francisco, CA 94117-1019 | 2013-04-30 |
| 1669561999 | Jason J Song | Internal Medicine | 300 Community Dr, Department of Cardiology, Manhasset, NY 11030-3816 | 2006-10-12 |
| Street Address |
2801 17TH ST UNIT 202 |
| City | SAINT CLOUD |
| State | FL |
| Zip Code | 34769-4939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336682764 | Palm Tree Interventional Pain Management, Pllc | Physical Medicine & Rehabilitation | 2801 17th St Unit 202, Saint Cloud, FL 34769-4939 | 2016-12-03 |
| 1326370271 | Zoe Jamila Gonzales-rabathaly | Physician Assistant | 2801 17th St Unit 202, Saint Cloud, FL 34769-4939 | 2010-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053877506 | Premier Med Pa | Clinic/Center | 2906 17th St., St Cloud, FL 34769 | 2019-02-20 |
| 1760975387 | Mayra Rosado | Psychologist | Carrousel Therapy Center, 3201 Budinger Ave., Saint Cloud, FL 34769 | 2018-06-08 |
| 1598282113 | Salud Urgent Care LLC | Clinic/Center | 3107 13th Street, Saint Cloud, FL 34769 | 2017-08-24 |
| 1710332671 | American Healthcare Community Behavioral Services LLC | Social Worker | 1203 Florida Ave., St. Cloud, FL 34769 | 2016-04-28 |
| 1215395785 | Elite Garden | Assisted Living Facility | 4319 Neptune Road, St Cloud, FL 34769 | 2016-01-29 |
| 1336506732 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 4660 13th Street, St. Cloud, FL 34769 | 2016-01-15 |
| 1306202064 | Megan Rose Mcclave | Registered Nurse | 524 13th Street, St. Cloud, FL 34769 | 2016-01-12 |
| 1821473133 | Angela Creager | Counselor | 446 Hamilton Park Circle, St. Cloud, FL 34769 | 2015-07-28 |
| 1730574906 | Jordico LLC | Assisted Living Facility | 4417 13th Street, Suite 142, Saint Cloud, FL 34769 | 2015-04-03 |
| 1255731667 | Judimar Rodriguez | Behavioral Analyst | 1605 Eastern Ave, Saint Cloud, FL 34769 | 2014-09-04 |
| Find all providers in zip 34769 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184044067 | Sakshi Kaul | Physical Medicine & Rehabilitation | 1200 6th Ave N, Saint Cloud, MN 56303-2736 | 2014-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161214 | Radius Medical Center LLC | Physical Medicine & Rehabilitation | 2425 E Commercial Blvd Ste 203, Fort Lauderdale, FL 33308-4062 | 2020-07-17 |
| 1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
| 1508320342 | Grigory Pogrebinsky Md Pa | Physical Medicine & Rehabilitation | 12450 Tamiami Trl S Unit E, North Port, FL 34287-1473 | 2019-01-25 |
| 1235611815 | Peter Danger Molina | Physical Medicine & Rehabilitation | 1190 Nw 95th St Ste 200, Miami, FL 33150-2064 | 2018-08-30 |
| 1497246540 | Restore Medical Partners Pllc | Physical Medicine & Rehabilitation | 333 Tamiami Trl S Ste 101, Venice, FL 34285-2425 | 2018-05-24 |
| 1568952240 | South Florida Physical Medicine and Rehabilitation Center LLC | Physical Medicine & Rehabilitation | 1200 S Main St Ste 200, Belle Glade, FL 33430-7808 | 2018-05-17 |
| 1235641655 | Boca Pain Care, Inc | Physical Medicine & Rehabilitation | 851 Meadows Rd Ste 213, Boca Raton, FL 33486-2348 | 2017-10-25 |
| 1558870477 | Pain Control Solutions II LLC | Physical Medicine & Rehabilitation | 8323 Nw 12th Street, Suite 115, Miami, FL 33126 | 2017-09-22 |
| 1245759851 | Chelsea Hakeem | Physical Medicine & Rehabilitation | 8936 77th Terrace East, Suit 101, Lakewood Ranch, FL 34202 | 2017-09-14 |
| 1508384165 | Destiny Therapy Center Inc | Physical Medicine & Rehabilitation | 7480 Fairway Dr., Suite 101, Miami Lakes, FL 33014 | 2017-09-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT CLOUD |
| Zip Code | 34769 |
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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.