DR. KEITH L MULLENGER (NPI# 1366481079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366481079 |
| Entity Type | Individual |
| Full Name | DR. KEITH L MULLENGER |
| Credential | M.D. |
| Practice Address |
875 Military Trl Jupiter FL 33458-5700 |
| Mailing Address |
5555 Anglers Ave Ste 24 Fort Lauderdale FL 33312-6653 |
| Practice Telephone | 5617489828 |
| Practice Fax Number | 5616304543 |
| Mailing Telephone | 9549626265 |
| Mailing Fax Number | 9548939595 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME89087 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
875 MILITARY TRL |
| City | JUPITER |
| State | FL |
| Zip Code | 33458-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104827229 | Sherryl A Ashberg | Family Medicine | 875 Military Trl, Ste 200, Jupiter, FL 33458-5700 | 2005-08-10 |
| 1912370321 | Optimal Wellness & Longevity Institute, LLC | Orthopaedic Surgery | 875 Military Trl, Suite 105, Jupiter, FL 33458-5700 | 2015-11-06 |
| 1225301526 | Jupiter Medical Group P A | Internal Medicine | 875 Military Trl, Suite 208, Jupiter, FL 33458-5700 | 2012-02-16 |
| 1558515106 | Michael E Schwartz Do Pa | Internal Medicine | 875 Military Trl, Suite 210, Jupiter, FL 33458-5700 | 2008-11-10 |
| 1871777680 | Health Promoters, LLC | Family Medicine | 875 Military Trl, Suite 200, Jupiter, FL 33458-5700 | 2007-12-28 |
| 1801085881 | Kevin Andrew Wilkes | Physician Assistant | 875 Military Trl, Suite 200, Jupiter, FL 33458-5700 | 2007-10-16 |
| 1558557520 | Stuart B. Krost M.d.p.a. | Physician Assistant | 875 Military Trl, Suite 105, Jupiter, FL 33458-5700 | 2007-09-24 |
| 1871625475 | Sunset Studies LLC | Internal Medicine | 875 Military Trl, Suite # 208, Jupiter, FL 33458-5700 | 2007-03-09 |
| 1396874160 | Sharon Parker Geraghty | Physician Assistant | 875 Military Trl, Ste 200, Jupiter, FL 33458-5700 | 2007-03-05 |
| 1073642849 | Mary Huser | Nurse Practitioner | 875 Military Trl, Suite 200, Jupiter, FL 33458-5700 | 2007-03-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538780978 | Palm Beach Concierge Pt, LLC | Physical Therapist | 1166 Egret Cir S, Jupiter, FL 33458 | 2020-04-27 |
| 1346714789 | Shirley Dumas Gilbert | Counselor | 1132 W Indiantown Rd Unit 202, Jupiter, FL 33458 | 2019-01-18 |
| 1326518986 | Donald George Williams Jr. | Pharmacist | 5500 Military Trail, Jupiter, FL 33458 | 2018-11-27 |
| 1306329693 | William A Tison IIi | Physician Assistant | 2055 Military Trail Suite 204, Jupiter, FL 33458 | 2018-09-12 |
| 1588146930 | Joanna Peros | Psychologist | 210 Jupiter Lakes Blvd. Unit 3102, Jupiter, FL 33458 | 2018-09-02 |
| 1528558301 | Brian Pratt | Registered Nurse | 871 University Blvd Apt 207, Jupiter, FL 33458 | 2018-05-16 |
| 1306352133 | Katherine Janis Rivera | Nurse Anesthetist, Certified Registered | Jupiter Medical Center 1210 Old Dixie Hwy, Jupiter, FL 33458 | 2017-12-15 |
| 1992235436 | Barborka Schmidt | Pharmacist | 6650 W Indiantown Road, Suite 100, Aarav Pharmacy LLC, Jupiter, FL 33458 | 2017-06-18 |
| 1114453834 | Elite-e Counseling | Social Worker | 2055 Military Trail Suite 306 Jupiter, Jupiter, FL 33458 | 2017-05-02 |
| 1669910667 | Kristy Lee Caronia | Nurse Anesthetist, Certified Registered | 175 Edenberry Ave, Jupiter, FL 33458 | 2017-02-09 |
| Find all providers in zip 33458 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063760288 | Ics Radiology, Inc. | Radiology | 345 Jupiter Lakes Blvd Ste 100, Jupiter, FL 33458-7100 | 2012-08-20 |
| 1598937104 | Bruce A Rodan Md Pa | Radiology | 111 Waterbridge Ln, Jupiter, FL 33458-7743 | 2008-03-24 |
| 1538248653 | Peter M Fitzer | Radiology | 115 Ocean Key Way, Jupiter, FL 33477-7359 | 2006-11-02 |
| 1659475705 | Kishorchandra J Parekh | Radiology | 134 Rosalia Ct, Jupiter, FL 33478-5405 | 2006-09-11 |
| 1972536241 | Marvin A Kupersmit | Radiology | 333 Regatta Dr, Jupiter, FL 33477-4077 | 2006-07-09 |
| 1831145218 | Michael Key D.o. | Radiology | 12530 152nd St N, Jupiter, FL 33478-3557 | 2006-05-26 |
| 1225027592 | Kyle R. Gormezano | Radiology | 500 Peacock Ln N, Jupiter, FL 33458-8333 | 2005-10-19 |
| 1477553428 | Michael A Gangloff | Radiology | 120 Sweet Bay Cir, Jupiter, FL 33458-2816 | 2005-07-29 |
| 1083943930 | Advanced Diagnostic Resources | Radiology | 500 University Blvd, Suite 114, Jupiter, FL 33458-2773 | 2009-12-23 |
| 1578756524 | Jose M. Fragoso | Radiology | 1210 S Old Dixie Hwy, Jupiter, FL 33458-7205 | 2007-08-23 |
| Find all providers in JUPITER | ||||
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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.