ANTI-AGING MEDICAL CENTER (NPI# 1265795207) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265795207 |
| Entity Type | Organization |
| Organization Name | ANTI-AGING MEDICAL CENTER |
| Other Organization Name | RESTORATIVE MEDICAL CENTER |
| Practice Address |
3545 Bobcat Village Center Rd North Port FL 34288-8977 |
| Practice Telephone | 9416250304 |
| Mailing Telephone | 9416250304 |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2012-06-22 |
| Authorized Official Name | CHRISTINA M PARKER (OWNER/ARNP) |
| Authorized Official Telephone | 3162073406 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9267806 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Other Name | Type Code |
|---|---|
| Restorative Medical Center | Doing Business As Name - Organization |
| Street Address |
3545 BOBCAT VILLAGE CENTER RD |
| City | NORTH PORT |
| State | FL |
| Zip Code | 34288-8977 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245787795 | Hope Diana | Dental Hygienist | 3026 Seth Road, North Port, FL 34288 | 2016-09-01 |
| 1942402946 | Melinda Wilson | Physical Therapy Assistant | 5999 Bibb Court, North Port, FL 34288 | 2007-06-01 |
| 1447314190 | Girish D. Patel | Internal Medicine | 2500 Bobcat Village Center Rd, Suite E, North Port, FL 34288 | 2006-12-20 |
| 1295804649 | Francisco V Ramirez IIi | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2006-11-07 |
| 1104878016 | William L Crouch Iv | Family Medicine | 2630 Bobcat Village Center Road, North Port, FL 34288 | 2006-05-17 |
| 1700398864 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 1500 Price Creek Way, North Port, FL 34288 | 2017-10-30 |
| 1629517321 | Ketul Shah | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2017-02-15 |
| 1881835569 | Northport Emergency Associates, Pa | Emergency Medicine | 2345 Bobcat Village Center Rd, North Port, FL 34288 | 2009-03-10 |
| 1417085069 | Pieter H. Tepaske | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2007-03-02 |
| 1932576733 | Erika Miley | Counselor | 1121 W Price Blvd # 107, North Port, FL 34288-1814 | 2015-08-27 |
| Find all providers in zip 34288 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396345930 | Katy Hernandez Castro | Nurse Practitioner | 4116 Symco Ave, North Port, FL 34286-4205 | 2020-10-30 |
| 1043850266 | Devon Snedeker | Nurse Practitioner | 1668 Nicollett Ave, North Port, FL 34286-1904 | 2020-01-15 |
| 1568945343 | Marian Malafarina | Nurse Practitioner | 4737 Andris St, North Port, FL 34288-7307 | 2018-09-08 |
| 1083099592 | Anne K Wharton | Nurse Practitioner | 1256 Lindsay Ave, North Port, FL 34286-2903 | 2015-07-26 |
| 1366840332 | Rachael Luther | Nurse Practitioner | 15131 Tamiami Trail, North Port, FL 34287-2711 | 2014-12-08 |
| 1427291103 | Melissa Joy Weiss | Nurse Practitioner | 1329 Patio Ter, North Port, FL 34286-4944 | 2009-04-11 |
| 1023102167 | Howard Pinsky | Nurse Practitioner | 12450 Tamiami Trail, Suite E, North Port, FL 34287-1932 | 2006-10-03 |
| 1295795045 | Maribel Gonzalez | Nurse Practitioner | 14243 Tamiami Trl, North Port, FL 34287-2215 | 2006-03-24 |
| 1013991629 | Denise K Costa | Nurse Practitioner | 2560 Commerce Pkwy, North Port, FL 34289-9348 | 2005-12-06 |
| 1962061101 | Michele Hodges | Nurse Practitioner | 6950 Outreach Way, North Port, FL 34287-3405 | 2019-06-11 |
| Find all providers in NORTH PORT | ||||
| City | NORTH PORT |
| Zip Code | 34288 |
Please comment or provide details below to improve the information on ANTI-AGING MEDICAL CENTER.
| 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.