DR. ALFONZA MCCOLLUM JR. (NPI# 1407844558) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407844558 |
| Entity Type | Individual |
| Full Name | DR. ALFONZA MCCOLLUM JR. |
| Credential | M.D. |
| Practice Address |
461 South Nova Road Ormond Beach FL 33174-6138 |
| Mailing Address |
P.o. Box 9671 Daytona Beach FL 32120-9671 |
| Practice Telephone | 3866714337 |
| Practice Fax Number | 3866717242 |
| Mailing Telephone | 3866767130 |
| Mailing Fax Number | 3866767125 |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2015-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME83401 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE NUMBER | P00444511 | 01 |
| FL | TRICARE | 1407844558 | 01 |
| FL | BCBS | 57851 | 01 |
| FL | 267116600 | 05 |
| Street Address |
461 SOUTH NOVA ROAD |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 33174-6138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619172137 | Erika Maria Faile | Family Medicine | 461 South Nova Road, Ormond Beach, FL 32174-6138 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790322931 | Gonzalez Medical & Rehabilitation Center LLC. | Clinic/Center | Gonzalez Medical & Rehabilitation Center LLC., 9600 Sw 8th Street Suite 26, Miami, FL 33174 | 2019-12-06 |
| 1942841655 | Eida J Alvarez | Pharmacist | 10332 W. Flager St., Miami, FL 33174 | 2019-10-03 |
| 1477021384 | Greyte Leyva Souto | Nurse Practitioner | 9856 Sw 8th St Apt 211, Miami, FL 33174 | 2018-11-08 |
| 1205322856 | Salome Fraga | Dentist | 9971 W Flagler Street, Suite 220, Miami, FL 33174 | 2018-07-06 |
| 1013425610 | Estuardo Del Peso | Nurse Practitioner | 345 Sw 97th Ct, Miami, FL 33174 | 2018-01-17 |
| 1477079911 | Jocelyn Hernandez | Behavior Technician | 10942 Sw 4st Apt 1, Miami, FL 33174 | 2017-08-16 |
| 1558885608 | Mariela Hernandez | Behavior Technician | 8770 Sw 12 Th St Apt 202, Miami, FL 33174 | 2017-07-31 |
| 1164943130 | Jesus Portal | Behavior Technician | 11262 Sw 7th St, Miami, FL 33174 | 2017-06-29 |
| 1033644877 | Enrique Barreiro | Assistant Behavior Analyst | 10801 Sw 7 St, Apt 2, Miami, FL 33174 | 2017-05-01 |
| 1528503893 | Damaris Quinones | Behavior Technician | 8900 West Flagler, Miami, FL 33174 | 2016-12-22 |
| Find all providers in zip 33174 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336756204 | Adventhealth Osceola South Inc | Family Medicine | 305 Clyde Morris Blvd Ste 130, Ormond Beach, FL 32174-8182 | 2020-09-25 |
| 1821568825 | Magdalena Kinga Skowronska | Family Medicine | 8 Mirror Lake Dr Ste A, Ormond Beach, FL 32174-3102 | 2018-12-03 |
| 1548753411 | Adrianna Sung | Family Medicine | 775 W Granada Blvd, Ormond Beach, FL 32174-5109 | 2018-06-14 |
| 1184132888 | Family Practice On The Go of Florida | Family Medicine | 226 N Nova Rd Ste 184, Ormond Beach, FL 32174-5124 | 2018-01-16 |
| 1275983587 | Angelic Alvarez | Family Medicine | 1050 W Granada Blvd Ste 2a, Ormond Beach, FL 32174-8155 | 2016-06-16 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1437563533 | Leslie Delvin Williams | Family Medicine | 1688 W Granada Blvd Ste 2a, Ormond Beach, FL 32174-1818 | 2014-06-17 |
| 1720401359 | Ronald Hinebaugh | Family Medicine | 80 Raintree Ln, Ormond Beach, FL 32174-4291 | 2014-02-03 |
| 1205265659 | There Care, Pa | Family Medicine | 334 Military Blvd, Ormond Beach, FL 32174-6019 | 2013-11-06 |
| 1144656950 | Savitha Kasturi, Do Pa | Family Medicine | 279 S Yonge Street, Ormond Beach, FL 32174 | 2013-09-25 |
| Find all providers in ORMOND BEACH | ||||
| City | ORMOND BEACH |
| Zip Code | 33174 |
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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.