MARK B DEKUTOSKI (NPI# 1386622348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386622348 |
| Entity Type | Individual |
| Full Name | MARK B DEKUTOSKI |
| Credential | MD |
| Practice Address |
155 Crystal Beach Dr Ste 200 Destin FL 32541-3588 |
| Practice Telephone | 8504602350 |
| Practice Fax Number | 8664901517 |
| Mailing Telephone | 8504602350 |
| Mailing Fax Number | 8664901517 |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2020-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | ME145588 | FL | Allopathic & Osteopathic Physicians |
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
ME145588 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
155 CRYSTAL BEACH DR STE 200 |
| City | DESTIN |
| State | FL |
| Zip Code | 32541-3588 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891798617 | Charles H Wingo | Orthopaedic Surgery | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2005-05-24 |
| 1275146011 | Emily Pettigrew | Physical Therapist | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2020-08-30 |
| 1164921458 | Shana Lynn Carter | Physical Therapist | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2018-02-01 |
| 1518341478 | Anna Lucille Braun | Nurse Practitioner | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2015-07-10 |
| 1336400704 | Spine Institute On The Emerald Coast | Orthopaedic Surgery | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2012-06-01 |
| 1891965844 | Pritesh K Patel | Physical Medicine & Rehabilitation | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2008-03-05 |
| 1659479475 | Lori Lynn Poelstra | Anesthesiology | 155 Crystal Beach Dr Ste 200, Ste 200, Destin, FL 32541-3588 | 2006-09-20 |
| 1497707145 | Victoria Ann Jarrett | Physician Assistant | 155 Crystal Beach Dr Ste 200, Destin, FL 32541-3588 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578020574 | Wal-mart Stores East, Lp | Durable Medical Equipment & Medical Supplies | Sec of Hwy 98 and Gulf Shore Drive, Destin, FL 32541 | 2019-02-26 |
| 1932640471 | Kathryn Clower | Chiropractor | 36474c Emerald Coast Pkwy Ste 3101, Destin, FL 32541 | 2017-03-16 |
| 1881133148 | Danielle Mckinney | Physical Therapist | 35008 Emerald Coast Pkwy Ste 400, Destin, FL 32541 | 2017-02-20 |
| 1417304643 | Coastal Pediatric Group | Pediatrics | 36468 Emerald Coast Pkwy Unit 2101, Destin, FL 32541 | 2016-05-17 |
| 1336563956 | Blu By The Sea,llc | Clinic/Center | 3399 Scenic Highway 98, Destin, FL 32541 | 2014-02-18 |
| 1740539535 | Courtney Breaux Mcgee | Physician Assistant | 155 Crystal Beach Drive #121, Destin, FL 32541 | 2012-09-07 |
| 1073861704 | Nathan Hall Dmd Pl | Dentist | 4484 Legendary Dr, Suite B, Destin, FL 32541 | 2012-08-28 |
| 1982991121 | Bayshore Retreat, LLC | Substance Abuse Rehabilitation Facility | 457 Cahoun Ave, Destin, FL 32541 | 2011-07-08 |
| 1457661605 | Destin Surgery Clinic, P.a. | Specialist | 415 Mountain Drive, Suite # 6, Destin, FL 32541 | 2010-10-20 |
| 1194032581 | Laura Mathisen | Behavioral Analyst | 3820 Misty Way, Destin, FL 32541 | 2010-09-07 |
| Find all providers in zip 32541 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487251740 | Aaron's Doctor Office | Orthopaedic Surgery | 7720 Us Highway 98 W, Destin, FL 32550-7230 | 2020-10-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386293215 | Citrus Spine Institute LLC | Orthopaedic Surgery | 1409 Kingsley Ave Ste 9f, Orange Park, FL 32073-4579 | 2019-09-04 |
| 1194383638 | Ortho Florida, LLC | Orthopaedic Surgery | 8190 S Jog Rd Ste 101, Boynton Beach, FL 33472-2911 | 2019-05-30 |
| 1821571175 | Orthopedic Spine Solutions Corp | Orthopaedic Surgery | 3852 Sheridan St, Hollywood, FL 33021-3634 | 2018-09-12 |
| 1194223461 | Select Health of Fl, LLC | Orthopaedic Surgery | 2 S Biscayne Blvd Ste 3760a, Miami, FL 33131-1815 | 2018-01-31 |
| 1568960839 | Spine Cin of Jacksonville LLC | Orthopaedic Surgery | 1301 Riverplace Blvd Ste 800a, Jacksonville, FL 32207-9047 | 2018-01-31 |
| 1912405283 | Spine Cin of Naples LLC | Orthopaedic Surgery | 8831 Business Park Dr Ste 301a, Fort Myers, FL 33912-2510 | 2018-01-31 |
| 1386142644 | Joint Replacement Cin of Naples LLC | Orthopaedic Surgery | 8831 Business Park Dr Ste 301b, Fort Myers, FL 33912-2510 | 2018-01-31 |
| 1366940140 | Joint Replacement Cin of Orlando LLC | Orthopaedic Surgery | 5401 S Kirkman Rd Ste 310b, Orlando, FL 32819-7940 | 2018-01-26 |
| 1811495690 | Joint Replacement Cin of Miami LLC | Orthopaedic Surgery | 2 S Biscayne Blvd Ste 3760b, Miami, FL 33131-1815 | 2018-01-26 |
| 1689182362 | Fss Keys LLC | Orthopaedic Surgery | 1111 12th St Ste 108, Key West, FL 33040-4087 | 2018-01-17 |
| Find all providers with the same taxonomy | ||||
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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.