EUGENE RAPHAEL VALENTINE (NPI# 1376561159) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376561159 |
| Entity Type | Individual |
| Full Name | EUGENE RAPHAEL VALENTINE |
| Credential | M.D. |
| Practice Address |
235 Carmel Dr Fort Walton Beach FL 32547-1957 |
| Practice Telephone | 8508623141 |
| Practice Fax Number | 8508627732 |
| Mailing Telephone | 8508623141 |
| Mailing Fax Number | 8508627732 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2010-01-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME12756 | FL | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
ME12756 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 052428000 | 05 | |
| FL | BLUE CROSS BLUE SHIELD | 46079 | 01 |
| Street Address |
235 CARMEL DR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-1957 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366468654 | Michas, Valentine & Gill, Psychiatric Associates, P.a. | Psychologist | 235 Carmel Dr, Fort Walton Beach, FL 32547-1957 | 2006-07-14 |
| 1366739344 | Sidney L Cary | Counselor | 235 Carmel Dr, Fort Walton Beach, FL 32547-1957 | 2011-06-29 |
| 1508900895 | Susan Kessler | Nurse Practitioner | 235 Carmel Dr, Fort Walton Beach, FL 32547-1957 | 2007-02-19 |
| 1164441937 | Catherine Rose Michas | Psychologist | 235 Carmel Dr, Fort Walton Beach, FL 32547-1957 | 2006-07-19 |
| 1396764163 | Wayne Cammer Richard | Psychologist | 235 Carmel Dr, Fort Walton Beach, FL 32547-1957 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184066672 | Alexander Adelsberger | Psychiatry & Neurology | 1000 Mar Walt Drive, Psychiatric Treatment Unit, Fort Walton Beach, FL 32547 | 2013-07-24 |
| 1447312749 | Marla D Michaels | Psychiatry & Neurology | 137 Hospital Dr Ne, Fort Walton Beach, FL 32548-5063 | 2006-12-14 |
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| 1952829137 | Child and Adolescent Tampa Bay Psychiatry, LLC | Psychiatry & Neurology | 100 S Ashley Dr Ste 600, Tampa, FL 33602-5300 | 2017-09-07 |
| 1386183580 | Dr2go, Inc | Psychiatry & Neurology | 8860 Sw 123rd Ct, Miami, FL 33186-4152 | 2017-02-21 |
| 1851746069 | Hannah Elizabeth Morrissey | Psychiatry & Neurology | University of Florida Psychiatry Residency, 4037 Nw 86th Terrace, Gainesville, FL 32610-0001 | 2016-04-26 |
| 1891150488 | Tampa Bay Psychiatric Services Pl | Psychiatry & Neurology | 5664 Marquesas Cir, Sarasota, FL 34233-3331 | 2015-12-23 |
| Find all providers with the same taxonomy | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
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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.