BRENT HAYDEN, M.D.,P.A. (NPI# 1326373606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326373606 |
Entity Type | Organization |
Organization Name | BRENT HAYDEN, M.D.,P.A. |
Practice Address |
733 Sw State Road 47 Lake City FL 32025-0453 |
Practice Telephone | 3867550645 |
Practice Fax Number | 3869619541 |
Mailing Telephone | 3867550645 |
Mailing Fax Number | 3869619541 |
Enumeration Date | 2009-10-05 |
Last Update Date | 2012-12-18 |
Authorized Official Name | DR. DONALD BRENT HAYDEN (PRESIDENT) |
Authorized Official Telephone | 3867550645 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | STATE LICENCE NUMBER | ME0043394 | 01 |
FL | 041891900 | 05 | |
FL | MEDICARE ID-TYPE UNSPECIFIED | 12066 | 01 |
Street Address |
733 SW STATE ROAD 47 |
City | LAKE CITY |
State | FL |
Zip Code | 32025-0453 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013061456 | Donald Brent Hayden | General Practice | 733 Sw State Road 47, Lake City, FL 32025-0453 | 2007-01-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801438353 | Jennifer Bennett | Pharmacist | 347 Sw Main Blvd Suite 102, Lake City, FL 32025 | 2019-10-16 |
1700352838 | Robert J Sansouci IIi IIi | Physical Therapy Assistant | 560 Sw Mcfarlane Ave, Lake City, Fl, 32025, Lake City, FL 32025 | 2018-10-16 |
1316442783 | Emily Bailey | Developmental Therapist | 2126 Sw Sisters Welcome Rd, Lake City, FL 32025 | 2018-03-28 |
1811446370 | Michelle Hart | Behavioral Analyst | 260 S. Marion Avenue, Bldg. A, Suite 135, Lake City, FL 32025 | 2016-09-26 |
1922467646 | Irene Aponte Moreno | Nurse Practitioner | 440 Sw Perimeter Glen, Lake City, FL 32025 | 2016-02-23 |
1093186777 | Decarlos Scippio | Counselor | 619 Sw Baya Drive Suite 102, Lake City, FL 32025 | 2015-10-07 |
1497132476 | Jamecia Legree | Registered Nurse | 800 Sw Symphony Loop, Bldg 15 Apt 204, Lake City, FL 32025 | 2015-04-29 |
1306249149 | Mercy Home Assisted Living Facility LLC | Assisted Living Facility | 184 S.e. Beech Street, Lake City, FL 32025 | 2014-10-08 |
1598174344 | Karen Mcdonald | Developmental Therapist | 4523 Se County Road 252, Lake City, FL 32025 | 2014-08-06 |
1275944126 | Mohammad Ali Faisal Mdpa | Specialist | 1283 Sw State Rd 47, Ste 104, Lake City, FL 32025 | 2014-05-14 |
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Taxonomy Code | 208D00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | General Practice |
Definition to come... |
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1407062391 | Jose Raul Garriga-diaz I | General Practice | 7906 E Us Highway 90, Lake City, FL 32055-6290 | 2007-05-15 |
1790900447 | Leopold Bejamin Leblique | General Practice | 264 Sw Ridgeview Pl., Lake City, FL 32024 | 2007-04-16 |
1013061456 | Donald Brent Hayden | General Practice | 733 Sw State Road 47, Lake City, FL 32025-0453 | 2007-01-23 |
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1477791465 | Karymar Del Valle Serrano | General Practice | 619 S Marion Ave, Lake City, FL 32025-5808 | 2009-01-28 |
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1134186455 | Carolinas Medical Alliance Inc | General Practice | 101 John St, Lake City, SC 29560-2411 | 2006-04-28 |
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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.