JENS BAGGESEN FLOCK IV (NPI# 1457779803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457779803 |
| Entity Type | Individual |
| Full Name | JENS BAGGESEN FLOCK IV |
| Practice Address |
303 N Clyde Morris Blvd Daytona Beach FL 32114-2709 |
| Practice Telephone | 3864254000 |
| Mailing Telephone | 3864254000 |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2020-10-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
ME146639 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 201153 | NC | Student, Health Care |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 201153 | 05 |
| Street Address |
303 N CLYDE MORRIS BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-2709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811991227 | Halifax Hospital Medical Center | Case Management | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2005-06-13 |
| 1447860374 | Priscilla Selig | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-08-05 |
| 1770123820 | Jane Hollis | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2020-01-07 |
| 1619512282 | Kristin Patrice Gardner | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-11-07 |
| 1447804364 | Brenda Martin Cohen | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-29 |
| 1285296574 | Cassie C Norris | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-07-08 |
| 1063077667 | Jara Apperley | Physician Assistant | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-05-08 |
| 1972068153 | Sreyboth Sreng | Nurse Practitioner | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2019-02-01 |
| 1356811244 | Matthew Evans | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2018-12-04 |
| 1932679503 | Amanda Gonzalez | Nurse Anesthetist, Certified Registered | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-11-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437579489 | Brandon Masi Parker | Surgery | 1611 Nw 12th Ave # 215, Miami, FL 33136-1005 | 2014-04-17 |
| 1508203100 | Kathleen Relihan | Surgery | 77 W Underwood St Ste 200, Orlando, FL 32806-1122 | 2013-05-23 |
| 1992998934 | Vivek Vijay Tirmal | Surgery | 607 Ne 11th Ave, Fort Lauderdale, FL 33304-4695 | 2007-08-23 |
| 1467657890 | Khaled Basiouny | Surgery | 603 7th St S Ste 500, St Petersburg, FL 33701-4734 | 2007-06-16 |
| 1417028614 | Derek Powell Brock | Surgery | 836 Lakeside Dr, North Palm Beach, FL 33408-3810 | 2006-11-11 |
| 1548278856 | Patrick Gonzalez Jr. | Surgery | 12651 N Dale Mabry Hwy, #272204, Tampa, FL 33688-9001 | 2006-08-03 |
| 1124061346 | Dana A. Taylor | Surgery | 1234 Se Magnolia Ext Unit 1, Ocala, FL 34471-3778 | 2006-06-14 |
| 1730163643 | Joseph Mcginn | Surgery | 8950 N Kendall Dr Ste 607w, Miami, FL 33176-2139 | 2005-12-05 |
| 1902429475 | Giovanni Jose Flumeri-perez | Surgery | 1431 Sw 1st Ave Bldg Suite7, Ocala, FL 34471-6500 | 2020-05-19 |
| 1194384297 | Jorge A. Vega Jr., M.d., Pllc | Surgery | 3375 Burns Rd Ste 206, Palm Beach Gardens, FL 33410-4361 | 2019-06-12 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
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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.