SOUTHEASTERN OSTEOPOROSIS SERVICES INC (NPI# 1407848211) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407848211 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN OSTEOPOROSIS SERVICES INC |
| Practice Address |
4511 N Davis Hwy Suite 1-c Pensacola FL 32503-2720 |
| Practice Telephone | 8504770775 |
| Mailing Telephone | 8504770775 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. STEPHEN D BAST (PRESIDENT) |
| Authorized Official Telephone | 8504770775 |
| Authorized Official Credential | P.A.-C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2471B0102X |
Radiologic Technologist Specialization: Bone Densitometry |
JR3419100 | FL | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 34252 | 05 | |
| FL | UNITED HEALTH CARE | 3405722 | 01 |
| Street Address |
4511 N DAVIS HWY SUITE 1-C |
| City | PENSACOLA |
| State | FL |
| Zip Code | 32503-2720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932102746 | Gary Gotthelf | Internal Medicine | 4511 N Davis Hwy, Ste C1, Pensacola, FL 32503-2720 | 2005-05-24 |
| 1538301957 | Jessica L. Locchead | Physician Assistant | 4511 N Davis Hwy, Ste 1-c, Pensacola, FL 32503-2720 | 2009-03-31 |
| 1306871694 | Stephen A Raybourn | Physician Assistant | 4511 N Davis Hwy, Pensacola, FL 32503-2720 | 2006-07-12 |
| 1841236726 | Comfort Care Medical Group Pa | Nurse Practitioner | 4511 N Davis Hwy, Ste 1-c, Pensacola, FL 32503-2720 | 2006-06-21 |
| 1821048646 | Elizabeth B. Jones | Nurse Practitioner | 4511 N Davis Hwy, Suite 1-c, Pensacola, FL 32503-2720 | 2006-05-11 |
| 1235197930 | Florida Diagnostic Imaging Center Inc | Radiology | 4511 N Davis Hwy, Suite 1-b, Pensacola, FL 32503-2720 | 2006-05-02 |
| 1679558795 | Carie A Fletcher | Family Medicine | 4511 N Davis Hwy, Ste C-1, Pensacola, FL 32503-2720 | 2005-12-12 |
| 1699767384 | Jennifer Lynn Richardson | Physician Assistant | 4511 N Davis Hwy, Suite C-1, Pensacola, FL 32503-2734 | 2005-08-18 |
| 1023000817 | Gary Gotthelf, M.d., P.a. | Internal Medicine | 4511 N Davis Hwy, 1-c, Pensacola, FL 32503-2720 | 2005-08-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134727472 | Lauren Barrett Evans | Nurse Practitioner | 4700 Bayou Boulevard, Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1528666864 | Kelsey Christine Kvartek | Nurse Practitioner | 4700 Bayou Blvd., Suite 6, Pensacola, FL 32503 | 2020-10-09 |
| 1730790551 | Sacred Heart Hospital of Pensacola | Podiatrist | 1890 Summit Blvd, Pensacola, FL 32503 | 2020-08-14 |
| 1891312815 | Sacred Heart Asc, LLC | Clinic/Center | 1890 Summit Boulevard, Suite 210, Pensacola, FL 32503 | 2020-06-26 |
| 1275011744 | Teresa T Jansen | Registered Nurse | 5051 Carpenters Creek Dr, Pensacola, FL 32503 | 2018-08-06 |
| 1639662729 | Florida Physical Therapy Services of Pensacola, LLC | Occupational Therapist | 428 Airport Blvd, Pensacola, FL 32503 | 2018-06-13 |
| 1922595123 | Touch of Love Home Health Care LLC | Home Health | 139 E Burgess Rd Ste B, Pensacola, FL 32503 | 2018-04-13 |
| 1770012106 | Amber Mcclellan | Occupational Therapist | 4551 North Davis Highway, Suite C, Pensacola, FL 32503 | 2017-06-08 |
| 1780123885 | Corinne Georgette-marie Carlson | Registered Nurse | 6809 White Oak Drive, Pensacola, FL 32503 | 2017-02-22 |
| 1538615232 | Kristin E Patton | Dietitian, Registered | 4501 North Davis Hwy, Suite C, Pensacola, FL 32503 | 2016-09-01 |
| Find all providers in zip 32503 | ||||
| Taxonomy Code | 2471B0102X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Bone Densitometry |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912967654 | Radiologic Heathcare Services | Radiologic Technologist | 1508 Bay Rd, Apt. 31, Miami Beach, FL 33139-3229 | 2006-03-26 |
| 1750388278 | Bmdmobile | Radiologic Technologist | 3109 Grand Ave, #437, Coconut Grove, FL 33133-5103 | 2005-06-29 |
| 1922351717 | Steven Garrett Goldberg | Radiologic Technologist | 20880 W Dixie Hwy, Miami, FL 33180-1151 | 2012-10-18 |
| 1104948561 | Silvestre Guerrero | Radiologic Technologist | 3360 Nw 72nd Ave, Miami, FL 33122-1320 | 2007-04-05 |
Please comment or provide details below to improve the information on SOUTHEASTERN OSTEOPOROSIS SERVICES INC.
| 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.