FIRST COAST CARDIOVASCULAR (NPI# 1265973911) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265973911 |
| Entity Type | Organization |
| Organization Name | FIRST COAST CARDIOVASCULAR |
| Practice Address |
205 Zeagler Dr Palatka FL 32177-3888 |
| Mailing Address |
Po Box 551308 Jacksonville FL 32255-1308 |
| Practice Telephone | 9044933333 |
| Practice Fax Number | 9044932222 |
| Mailing Telephone | 9044933333 |
| Mailing Fax Number | 9044932222 |
| Enumeration Date | 2017-03-14 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | DR. YAZAN KHATIB (PRESIDENT) |
| Authorized Official Telephone | 9044933333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467986737 | First Coast Cardiovascular | Internal Medicine | 725 S 6th St, Macclenny, FL 32063-9653 | 2017-04-13 |
| 1790226447 | First Coast Cardiovascular | Internal Medicine | 5233 Ricker Rd, Suite 101, Jacksonville, FL 32210-1438 | 2017-03-14 |
| 1083155725 | First Coast Cardiovascular | Internal Medicine | 3890 Dunn Ave, Ste 203, Jacksonville, FL 32218-6428 | 2017-03-14 |
| 1811438559 | First Coast Cardiovascular | Internal Medicine | 9759 San Jose Blvd, Ste 2, Jacksonville, FL 32257-4401 | 2017-03-14 |
| 1659812394 | First Coast Cardiovascular | Internal Medicine | 665 State Road 207, Suite 102, St Augustine, FL 32084-5938 | 2017-03-14 |
| 1255872982 | First Coast Cardiovascular | Internal Medicine | 1681 Eagle Harbor Pkwy, Ste B, Fleming Island, FL 32003-4819 | 2017-03-14 |
| 1154862803 | First Coast Cardiovascular | Internal Medicine | 1201 Monument Rd, Suite 201b, Jacksonville, FL 32225-7411 | 2017-03-14 |
| Street Address |
205 ZEAGLER DR |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-3888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184671844 | Jack M. Matheny II, M.d. | Internal Medicine | 205 Zeagler Dr, Ste 101, Palatka, FL 32177-3888 | 2006-05-28 |
| 1427301670 | Physicians Group Services Pa | Surgery | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2012-10-24 |
| 1225262108 | Michael Allen Hicks | Nurse Practitioner | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2009-05-07 |
| 1740490945 | Jeffrey Reid Slotten | Dentist | 205 Zeagler Dr, Suite 502, Palatka, FL 32177-3888 | 2007-05-23 |
| 1457561672 | Jeffrey R. Slotten | Clinic/Center | 205 Zeagler Dr, Suite 502, Palatka, FL 32177-3888 | 2007-05-23 |
| 1407066582 | Richard A. Perallon | Dentist | 205 Zeagler Dr, Suite 301, Palatka, FL 32177-3888 | 2007-05-23 |
| 1154459832 | Julie Catherine Grout | Physical Therapist | 205 Zeagler Dr, Suite 401, Palatka, FL 32177-3888 | 2007-03-02 |
| 1598810343 | Anthony J Pacitti | Surgery | 205 Zeagler Dr, Suite 203, Palatka, FL 32177-3888 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598878670 | Putnam Heart Center Pa | Internal Medicine | 6710 Old Wolf Bay Rd, Palatka, FL 32177-6830 | 2006-08-16 |
| 1992023741 | Putnam Physician Practices LLC | Internal Medicine | 3314 Crill Ave, Suite 1a, Palatka, FL 32177-4162 | 2010-05-04 |
| 1932430071 | Abdul Lateef Bhatti, Md, Pa | Internal Medicine | 524 Zeagler Dr, Palatka, FL 32177-3813 | 2010-01-28 |
| 1366649766 | Northeast Florida Cardiology Pa | Internal Medicine | 6710 Old Wolf Bay Rd, Palatka, FL 32177-6830 | 2007-06-28 |
| 1770618837 | Mukesh Goel | Internal Medicine | 6710 Old Wolf Bay Rd, Palatka, FL 32177 | 2007-02-22 |
| 1982762712 | Mohammed Kaleem | Internal Medicine | 700 Zeagler Dr, Suite 2, Palatka, FL 32177-6806 | 2006-12-05 |
| 1063597912 | Alfred Thomas Romero | Internal Medicine | 6710 Old Wolf Bay Rd, Palatka, FL 32177-6830 | 2006-10-26 |
| 1023029154 | Cardio Care Center Inc. | Internal Medicine | 700 Zeagler Dr, Suite 2, Palatka, FL 32177 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437765443 | Premier Cardiovascular Center, LLC | Internal Medicine | 450 W State Road 434 Ste 2010, Longwood, FL 32750-5187 | 2020-09-16 |
| 1679199236 | Tallahassee Memorial Healthcare Inc | Internal Medicine | 877 3rd St Ste 3, Chipley, FL 32428-1855 | 2020-06-19 |
| 1972123701 | Heart Clinic of Central Florida LLC | Internal Medicine | 52 Riley Rd # 429, Celebration, FL 34747-5420 | 2020-04-22 |
| 1205465440 | Cardiology Group Panel LLC | Internal Medicine | 201 Nw 82nd Ave Ste 405, Plantation, FL 33324-1883 | 2020-04-08 |
| 1346876745 | H & D Cardiology, Pa | Internal Medicine | 1879 Nightingale Ln Ste B2, Tavares, FL 32778-4363 | 2020-03-17 |
| 1427690775 | The Cardiac and Vascular Institute Ambulatory Surgery Center | Internal Medicine | 4645 Nw 8th Ave Ste 10, Gainesville, FL 32605-4688 | 2019-10-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1023660255 | Florida Medical Specialists LLC | Internal Medicine | 1250 S Tamiami Trl Ste 300, Sarasota, FL 34239-2221 | 2019-07-09 |
| 1962064493 | Ckk Medical LLC | Internal Medicine | 6600 Sw State Road 200 # 200, Ocala, FL 34476-5554 | 2019-07-04 |
| 1952968026 | Jose Miguel Simo | Internal Medicine | 3347 S State Road 7 Ste 205, Wellington, FL 33449-8148 | 2019-05-23 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FIRST COAST CARDIOVASCULAR.
| 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.