MR. ANDREW WASILUK (NPI# 1457455719) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457455719 |
| Entity Type | Individual |
| Full Name | MR. ANDREW WASILUK |
| Credential | MD |
| Practice Address |
3129 Hendricks Avenue Jacksonville FL 32207-4217 |
| Practice Telephone | 9043988266 |
| Practice Fax Number | 9043964803 |
| Mailing Telephone | 9043988266 |
| Mailing Fax Number | 9043964803 |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2010-11-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
ME73313 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 259035200 | 05 |
| Street Address |
3129 HENDRICKS AVENUE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-4217 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871800763 | Hem Prakash Chataut | Internal Medicine | 3129 Hendricks Avenue, Jacksonville, FL 32207-4217 | 2010-09-13 |
| 1699836767 | Louis F Gregory and R Glenn Davis | Internal Medicine | 3129 Hendricks Avenue, Jacksonville, FL 32207-4217 | 2006-12-13 |
| 1013078179 | Robert Glenn Davis | Internal Medicine | 3129 Hendricks Avenue, Jacksonville, FL 32207-4217 | 2006-12-13 |
| 1912095233 | Roy Edward Crumley-forest | Nurse Practitioner | 3129 Hendricks Avenue, Jacksonville, FL 32207-4217 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629499090 | Pro-med Collectors LLC | Internal Medicine | 1907 Atlantic Blvd, Jacksonville, FL 32207-3466 | 2014-01-02 |
| 1821275330 | Nephrology Consultants of Jacksonville LLC | Internal Medicine | 3129 Hendricks Ave, Jacksonville, FL 32207-4217 | 2008-01-28 |
| 1811924210 | Naeem Haider | Internal Medicine | 3599 University Blvd So, Suite 805, Jacksonville, FL 32216 | 2006-06-28 |
| 1265474209 | Koithara Varkey Thomas | Internal Medicine | Eastern Nephrology Associates, 277 Memorial Drive, Jacksonville, NC 28546-6333 | 2006-06-12 |
| 1457917304 | Cardiorenal Therapeutics LLC | Internal Medicine | 6817 Southpoint Pkwy Ste 203, Jacksonville, FL 32216-6286 | 2019-05-16 |
| 1619434586 | Md. Irtiza Hasan | Internal Medicine | 655 W 8th St Fl 4, Jacksonville, FL 32209-6511 | 2019-02-26 |
| 1578058939 | Nephrology Consultants of Jacksonville LLC | Internal Medicine | 3129 Hendricks Ave, Jacksonville, FL 32207-4217 | 2018-06-28 |
| 1396283628 | A Abdalla, Inc | Internal Medicine | 5685 Norwood Ave, Jacksonville, FL 32208-5012 | 2017-02-07 |
| 1982141412 | Universal Kidney Care LLC | Internal Medicine | 10752 Deerwood Park Blvd Ste 100, Jacksonville, FL 32256-4846 | 2017-01-23 |
| 1629439740 | Mahnoor Khan | Internal Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2016-03-16 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
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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.