KELSEY BRAGG MESTROVIC (NPI# 1447614300) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447614300 |
| Entity Type | Individual |
| Full Name | KELSEY BRAGG MESTROVIC |
| Other Name | KELSEY BRAGG |
| Credential | PHYSICIAN ASSISTANT |
| Practice Address |
1150 North 35th Avenue Suite 555 Hollywood FL 33021 |
| Mailing Address |
2900 Corporate Way Door D Miramar FL 33025-3925 |
| Practice Telephone | 9542650072 |
| Practice Fax Number | 9549810188 |
| Mailing Telephone | 9542765685 |
| Mailing Fax Number | 9549857074 |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2018-04-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA 9109394 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1150 NORTH 35TH AVENUE SUITE 555 |
| City | HOLLYWOOD |
| State | FL |
| Zip Code | 33021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235404633 | Marjorie Bredy | Nurse Practitioner | 1150 North 35th Avenue, Suite 130, Hollywood, FL 33021 | 2012-03-19 |
| 1467961243 | Cristina Callahan | Psychologist | 1150 North 35th Avenue, Suite 520, Hollywood, FL 33021 | 2017-09-25 |
| 1497284178 | Paulette Baldie | Nurse Practitioner | 1150 North 35th Avenue, Suite 330, Hollywood, FL 33021-5488 | 2017-06-07 |
| 1700257102 | Christine Monique Triporo | Physician Assistant | 1150 North 35th Avenue, Suite 575, Hollywood, FL 33021-5469 | 2015-10-12 |
| 1558781906 | Toni Patricia Lattibeaudiere | Nurse Practitioner | 1150 North 35th Avenue, Suite 205a, Hollywood, FL 33021 | 2014-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548893894 | Seminole Tribe of Florida Health Department | Pharmacy | 111 W. Coral Way, Hollywood, FL 33021 | 2020-02-14 |
| 1437714086 | Emilia Roxana Gucciardo | Physician Assistant | 4510 Sheridan Street, Attn: William Pepe, Hollywood, FL 33021 | 2019-05-08 |
| 1649763673 | Sabrina Shoba Mathura | Behavior Technician | 4400 Madison St, Hollywood, FL 33021 | 2018-06-13 |
| 1558850149 | South Broward Hospital District | Pediatrics | 105 Joe Dimaggio Dr, Pediatric Heart Station, Hollywood, FL 33021 | 2018-05-09 |
| 1942798368 | Kyndra Monique Liburd | Student in an Organized Health Care Education/Training Program | Attn: Pediatric Residency Program, 1005 Joe Dimaggio Drive, Hollywood, FL 33021 | 2018-05-01 |
| 1992292106 | Madeleine Mariela Reyes | Nurse Practitioner | 5010 Hollywood Boulevard #100-b, Hollywood, FL 33021 | 2018-04-13 |
| 1487168233 | Gynecologic Oncology & Urogynecology | Obstetrics & Gynecology | 1150 N 35th Ave Ste 670, Hollywood, FL 33021 | 2017-11-30 |
| 1245743012 | Healix Healthcare Services, LLC | Obstetrics & Gynecology | 3990 Sheridan St Ste 207, Hollywood, FL 33021 | 2017-11-14 |
| 1093233587 | Benjamin Laborde | Physical Therapy Assistant | 4200 Washington Street, Hollywood, FL 33021 | 2017-09-05 |
| 1477079358 | Tt Trans, LLC | Non-emergency Medical Transport (VAN) | 3550 Washington Street, 502, Hollywood, FL 33021 | 2017-08-22 |
| Find all providers in zip 33021 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629608047 | Sadelyn De Los Santos | Physician Assistant | 251 N 71st Ter, Hollywood, FL 33024-7364 | 2020-01-24 |
| 1306486873 | Selina Batchanoo | Physician Assistant | 2310 Mckinley St, Hollywood, FL 33020-3057 | 2020-01-13 |
| 1972168706 | Kelly Maria Munoz | Physician Assistant | 4102 Trenton Ave, Hollywood, FL 33026-4924 | 2019-05-07 |
| 1982268132 | Michelle Vann | Physician Assistant | 4501 Johnson St, Hollywood, FL 33021-5311 | 2019-04-23 |
| 1023587839 | Mithra Moon | Physician Assistant | 1600 Vine St Apt 543, Hollywood, CA 90028-8825 | 2018-11-21 |
| 1447741509 | Franziska Goetz | Physician Assistant | 3550 Washington St Apt 512, Hollywood, FL 33021-8264 | 2018-05-24 |
| 1740730779 | Priya Philip | Physician Assistant | 4184 Cascada Cir, Hollywood, FL 33024-8516 | 2016-10-13 |
| 1215480488 | Robyn Dauerman | Physician Assistant | 4340 Sheridan St Ste 201, Hollywood, FL 33021-3568 | 2016-07-25 |
| 1881066272 | Mariana Racovita | Physician Assistant | 3700 Washington St Ste 404, Hollywood, FL 33021-8249 | 2015-10-23 |
| 1902132145 | Kimberly Ann Monahan | Physician Assistant | 3440 Hollywood Blvd., Suite 460, Hollywood, FL 33021 | 2009-10-22 |
| Find all providers in HOLLYWOOD | ||||
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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.