OBAYDAH AHMAD ABDURRAQEEB (NPI# 1316101264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316101264 |
| Entity Type | Individual |
| Full Name | OBAYDAH AHMAD ABDURRAQEEB |
| Credential | DO |
| Practice Address |
17 Silver Palm Ave Melbourne FL 32901-3123 |
| Mailing Address |
Po Box 1137 Melbourne FL 32902-1137 |
| Practice Telephone | 3217332021 |
| Practice Fax Number | 3217270884 |
| Mailing Telephone | 3219529696 |
| Mailing Fax Number | 3219527937 |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2014-08-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS11259 | FL | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | DO2182 | TN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAL LICENSE | OS11259 | 01 |
| TN | 1524832 | 05 | |
| TN | MEDICAID GRP UFP | 3373352 | 01 |
| TN | MEDICARE GRP UFP | 3373352 | 01 |
| Street Address |
17 SILVER PALM AVE |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568454486 | Lynette M Graff | Family Medicine | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2005-08-17 |
| 1063929479 | Michael Griffin | Nurse Practitioner | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2018-01-08 |
| 1336306240 | Chandra Mangra | Family Medicine | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2008-05-19 |
| 1689868622 | Charles Eugene Potts | Internal Medicine | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2007-09-04 |
| 1619026218 | Brevard Health Alliance | Clinic/Center | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2007-01-10 |
| 1528115458 | Brevard Health Alliance Inc | Clinic/Center | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2007-01-04 |
| 1598704066 | Hui Ping Chang | Nurse Practitioner | 17 Silver Palm Ave, Melbourne, FL 32901-3123 | 2006-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558970277 | Kimberly Gayle Ross | Family Medicine | 1919 Slone Blvd, Melbourne, FL 32935-4756 | 2020-07-28 |
| 1245706423 | Vargas Medical Services LLC | Family Medicine | 606 Sheridan Rd, Melbourne, FL 32901-3227 | 2018-10-16 |
| 1013467554 | First Locums Inc | Family Medicine | 3248 Cortona Dr, Melbourne, FL 32940-8613 | 2016-10-07 |
| 1922327774 | Angela Matthews | Family Medicine | 2694 Judge Fran Jamieson Way, Overflow Parking Lot, Melbourne, FL 32940 | 2010-05-19 |
| 1013197201 | Lauren Romeo Md Pa | Family Medicine | 1698 W Hibiscus Blvd Ste B, Melbourne, FL 32901-2639 | 2007-11-06 |
| 1023220605 | Marta Cyzio | Family Medicine | 1368 Tipperary Dr, Melbourne, FL 32940-6030 | 2007-05-04 |
| 1578787941 | Donna J. Badolato, Md, Pa | Family Medicine | 8061 Spyglass Hill Rd., Suite 102, Melbourne, FL 32940 | 2007-04-13 |
| 1801914858 | Marilyn C. Moss, M.d. | Family Medicine | 3210 N Wickham Rd, Suite 1, Melbourne, FL 32935-2300 | 2007-03-27 |
| 1639217870 | Kenneth Robert Mcelynn | Family Medicine | 7925 N Wickham Rd Ste B, Melbourne, FL 32940-8211 | 2007-02-01 |
| 1760568935 | Kristine R Everding | Family Medicine | 2002 Pennwood Dr, Melbourne, FL 32901-5934 | 2006-10-31 |
| Find all providers in MELBOURNE | ||||
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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.