JAMES E PROVO (NPI# 1346278264) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346278264 |
| Entity Type | Individual |
| Full Name | JAMES E PROVO |
| Credential | MD |
| Practice Address |
9325 Glades Rd Suite 205 Boca Raton FL 33434-3988 |
| Practice Telephone | 5613147200 |
| Practice Fax Number | 5613147201 |
| Mailing Telephone | 5613147200 |
| Mailing Fax Number | 5613147201 |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2013-02-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | ME67309 | FL | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
ME67309 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS BLUE SHIELD | 27095 | 01 |
| FL | 377506200 | 05 |
| Street Address |
9325 GLADES RD SUITE 205 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33434-3988 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265437891 | Jordan Blake Schwartzberg | Dermatology | 9325 Glades Rd, Suite 207, Boca Raton, FL 33434-3988 | 2005-06-20 |
| 1225491285 | Chirocare of Boca Raton, LLC | Chiropractor | 9325 Glades Rd, # 108, Boca Raton, FL 33434-3988 | 2016-03-29 |
| 1992173603 | Genesiscare Usa of Florida LLC | Surgery | 9325 Glades Rd, Suite 101, Boca Raton, FL 33434-3988 | 2015-09-11 |
| 1356735377 | Neurospine Institute LLC | Durable Medical Equipment & Medical Supplies | 9325 Glades Rd, Ste 205, Boca Raton, FL 33434-3988 | 2015-03-27 |
| 1871841585 | Sa Medical Physicians of Fl Pa | Specialist | 9325 Glades Rd, Suite 105, Boca Raton, FL 33434-3988 | 2012-08-28 |
| 1730455130 | Ortho Florida LLC | Orthopaedic Surgery | 9325 Glades Rd, Suite 205, Boca Raton, FL 33434-3988 | 2012-03-29 |
| 1063788099 | Palm Beach Counseling, LLC | Counselor | 9325 Glades Rd, Suite 208, Boca Raton, FL 33434-3988 | 2012-03-23 |
| 1861764136 | Josephine Whalen | Psychologist | 9325 Glades Rd, Suite 208, Boca Raton, FL 33434-3988 | 2012-02-02 |
| 1275827552 | Amanda Bartell | Counselor | 9325 Glades Rd, Suite 208, Boca Raton, FL 33434-3988 | 2011-06-04 |
| 1407146301 | Sina Menashehoff | Physical Medicine & Rehabilitation | 9325 Glades Rd, Suite 205, Boca Raton, FL 33434-3988 | 2011-04-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952943771 | Solutionist Counseling Services, LLC | Clinic/Center | 9250 West Glades Rd Suite 209, Boca Raton, FL 33434 | 2019-10-14 |
| 1962932582 | Karelys Hernandez | Developmental Therapist | 9293 Southampton Pl, Boca Raton, FL 33434 | 2017-06-15 |
| 1568996007 | Aurelie Huyghues-despointes | Dentist | 3003 W Yamato Rd Ste C5, Boca Raton, FL 33434 | 2017-04-11 |
| 1700334240 | Kinex Medical Company, LLC | Durable Medical Equipment & Medical Supplies | 20555 Boca Rio Road, Unit 1604, Boca Raton, FL 33434 | 2016-09-13 |
| 1952858342 | Melissa Kornhaus | Counselor | 7777 Glades Rd Ste 205, Boca Raton, FL 33434 | 2016-09-02 |
| 1023491800 | D. One Pharmacy Corp. | Pharmacy | 9070 Kimberly Blvd., Ste 27, Boca Raton, FL 33434 | 2015-06-30 |
| 1053707604 | Izdean Mufleh | Internal Medicine | 8903 Glades Rd Ste K1a, Boca Raton, FL 33434 | 2015-04-10 |
| 1437435310 | Tahmineh Hojjat | Pharmacist | 9851 West Glades Road, Boca Raton, FL 33434 | 2011-10-24 |
| 1962783191 | Sharon Sokolow | Nutritionist | 9033 Glades Rd., Boca Raton, FL 33434 | 2011-09-01 |
| 1093014714 | Sandra Jean Donovan Monteagudo | Hearing Instrument Specialist | 8903 Glades Rd., Suite A-15, Boca Raton, FL 33434 | 2011-03-21 |
| Find all providers in zip 33434 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://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 Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720607484 | Black Stallion Walk-in and Exercise Medicine Clinics LLC | Family Medicine | 9955 Se Federal Hwy, Hobe Sound, FL 33455-4829 | 2020-04-13 |
| 1003371519 | Affordable Medical Clinic of Wellii | Family Medicine | 12773 Forest Hill Blvd Ste 1203, Wellington, FL 33414-4760 | 2019-02-08 |
| 1609391929 | Baptist Physician Group LLC | Family Medicine | 8880 Navarre Pkwy Ste 206, Navarre, FL 32566-3614 | 2017-08-08 |
| 1568997880 | Sports Medicine and Rehab Fitness | Family Medicine | 4405 Crooked Mile Rd, Merritt Island, FL 32952-6310 | 2017-04-24 |
| 1770037822 | Daniel Gonzalez | Family Medicine | 11050 Griffin Rd, Davie, FL 33328-3226 | 2016-08-06 |
| 1497174478 | John Sami Maarouf | Family Medicine | 301 Harbour Place Dr Unit 2007, Tampa, FL 33602-6808 | 2014-04-07 |
| 1487091393 | Michelle Henne | Family Medicine | 5535 Cypress Gardens Blvd Ste 270, Winter Haven, FL 33884-2241 | 2013-05-31 |
| 1053678151 | Jonathan Paul Bonnet | Family Medicine | 4830 Nw 43rd St, M194, Gainesville, FL 32606-4401 | 2012-04-13 |
| 1891092862 | Ozaki, Inc. | Family Medicine | 1600 S Ocean Dr Apt 17d, Hollywood, FL 33019-2427 | 2011-02-28 |
| 1174839161 | John Broussard | Family Medicine | 111 2nd Ave Ne Ste 1401, St Petersburg, FL 33701-3480 | 2010-08-27 |
| Find all providers with the same taxonomy | ||||
| City | BOCA RATON |
| Zip Code | 33434 |
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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.