RESTORATION MEDICINE LLC (NPI# 1386975415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386975415 |
| Entity Type | Organization |
| Organization Name | RESTORATION MEDICINE LLC |
| Practice Address |
190 S Sykes Creek Pkwy Suite #3 Merritt Island FL 32952-3572 |
| Practice Telephone | 3213056254 |
| Practice Fax Number | 3213055972 |
| Mailing Telephone | 3213056254 |
| Mailing Fax Number | 3213055972 |
| Enumeration Date | 2010-01-29 |
| Last Update Date | 2011-04-11 |
| Authorized Official Name | DR. LANCE ANDRE MAKI (PRESIDENT) |
| Authorized Official Telephone | 3213056254 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
ME92412 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
190 S SYKES CREEK PKWY SUITE #3 |
| City | MERRITT ISLAND |
| State | FL |
| Zip Code | 32952-3572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619972668 | Timothy Michael Wahl | Dentist | 190 S Sykes Creek Pkwy, Ste 2, Merritt Island, FL 32952-3572 | 2005-06-16 |
| 1952760365 | Brevard Pain Care, Pa | Specialist | 190 S Sykes Creek Pkwy, Suite 1, Merritt Island, FL 32952-3572 | 2016-02-12 |
| 1982877221 | Ash Dermatology & Skin Cancer Center, Pa | Dermatology | 190 S Sykes Creek Pkwy, Suite 3, Merritt Island, FL 32952-3572 | 2008-04-08 |
| 1255463709 | Mahmoud A El-tobgui | Specialist | 190 S Sykes Creek Pkwy, Merritt Island, FL 32952-3572 | 2007-03-11 |
| 1043342595 | Brevard Pain Care Pa | Specialist | 190 S Sykes Creek Pkwy, Suite 1, Merritt Island, FL 32952-3572 | 2007-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841761673 | Pushpa Daliya | Physical Medicine & Rehabilitation | 1200 S Courtenay Pkwy, Merritt Island, FL 32952 | 2018-12-05 |
| 1407335458 | Merritt Island Outpatient Surgery Center, LLC | Clinic/Center | 450 E Merritt Island Cswy Ste 400, Merritt Island, FL 32952 | 2018-08-10 |
| 1760903272 | Harold A Utt Jr. | Audiologist | 105 N. Banana River Drive, Merritt Island, FL 32952 | 2017-07-06 |
| 1942720982 | Cadiz Senior Care | Assisted Living Facility | 1970 Farrington Drive, Merritt Island, FL 32952 | 2017-06-21 |
| 1891230884 | Jessica Orcel | Behavioral Analyst | 1680 E. Central Avenue, Merritt Island, FL 32952 | 2016-12-29 |
| 1770039539 | Haley Haskins | Student in an Organized Health Care Education/Training Program | 1655 Yates Dr., Merritt Island, FL 32952 | 2016-08-31 |
| 1891150900 | Kristin Stevenson | Case Management | 262 Island Beach Blvd, Mirritt Island, FL 32952 | 2015-12-17 |
| 1568835080 | Brilliant Smiles Orthodontics | Health Maintenance Organization | 455 Magnolia Avenue, Merritt Island, FL 32952 | 2015-11-05 |
| 1184967184 | Roseann Judith Simone | Assisted Living Facility | 280 Bahama Dr, Angel Guardian, Cocoa Beach, FL 32952 | 2013-03-28 |
| 1942558861 | Daven H Patel | Dentist | 800 E. Merritt Island Causeway, Merritt Island, FL 32952 | 2012-08-27 |
| Find all providers in zip 32952 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033203633 | Sally Harris Sange | Obstetrics & Gynecology | 210 N Grove Street, Merritt Island, FL 32953-3444 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053910240 | Jeffrey M Greenberg Md Medical Services Inc | Obstetrics & Gynecology | 13324 Pond Apple Dr W, Naples, FL 34119-8556 | 2020-10-20 |
| 1497365464 | Hamel Foundation Inc | Obstetrics & Gynecology | 7777 N University Dr Ste 206, Tamarac, FL 33321-6106 | 2020-08-05 |
| 1336786466 | Manfred Emil Trostel | Obstetrics & Gynecology | 2425 Gulf of Mexico Dr Unit 8d, Longboat Key, FL 34228-3213 | 2019-12-09 |
| 1790335164 | Customized Wellness, LLC | Obstetrics & Gynecology | 131 W Center Avenue, Sebring, FL 33870 | 2019-09-17 |
| 1649737552 | Joe Walker Bancroft Jr. | Obstetrics & Gynecology | 4618 Long Bow Rd. South, Jacksonville, FL 32210-8144 | 2019-02-27 |
| 1649748666 | Kristin M Jackson LLC | Obstetrics & Gynecology | 260 Lookout Pl Ste 201, Maitland, FL 32751-4485 | 2018-11-07 |
| 1710476239 | Yvette Pereyra Ans | Obstetrics & Gynecology | 3990 Sheridan St Ste 214, Hollywood, FL 33021-3656 | 2018-05-10 |
| 1194223800 | Vandyke Md Ob/gyn Pa | Obstetrics & Gynecology | 9161 Narcoossee Rd Ste B209, Orlando, FL 32827-5764 | 2018-01-28 |
| 1538676515 | Adam Ostrzenski | Obstetrics & Gynecology | 7001 Central Ave Ste 3, St Petersburg, FL 33710-7549 | 2017-12-29 |
| 1144735945 | Judith Watson Bradfield | Obstetrics & Gynecology | 8024 Links Way, Port St Lucie, FL 34986-3035 | 2017-12-04 |
| Find all providers with the same taxonomy | ||||
| City | MERRITT ISLAND |
| Zip Code | 32952 |
Please comment or provide details below to improve the information on RESTORATION MEDICINE LLC.
| 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.