MR. RANDALL PANCKERI (NPI# 1467084533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467084533 |
| Entity Type | Individual |
| Full Name | MR. RANDALL PANCKERI |
| Practice Address |
10245 Sw Village Pkwy Apt 304 Port St Lucie FL 34987-2365 |
| Practice Telephone | 7325526295 |
| Mailing Telephone | 7325526295 |
| Enumeration Date | 2020-02-06 |
| Last Update Date | 2020-02-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 171W00000X | Contractor | FL | Other Service Providers | |
| Y | 171W00000X | Contractor | Other Service Providers |
| Street Address |
10245 SW VILLAGE PKWY APT 304 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34987-2365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093299604 | Karen Cecilia Wong Li James | Registered Nurse | 10024 Sw Glenbrook Drive, Port Saint Lucie, FL 34987 | 2018-09-19 |
| 1134646151 | B & T Diagnostics LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 323, Port Saint Lucie, FL 34987 | 2017-08-30 |
| 1538684048 | Transport With Care, LLC | Non-emergency Medical Transport (VAN) | 1850 Sw Our Ct, Port Saint Lucie, FL 34987 | 2017-08-04 |
| 1154859825 | True Path Diagnostics, LLC | Clinical Medical Laboratory | 11350 Sw Village Pkwy Ste 309, Port St Lucie, FL 34987 | 2017-05-25 |
| 1316326515 | Aleksey Alekseyenko | Family Medicine | Mhpg Primary Care @ Tradition Health Park II, 10080 Sw Innovation Way Suite 201, Port St Lucie, FL 34987 | 2015-05-21 |
| 1053658583 | Tameka Argo | Contractor | 7664 Germany Canal Road, Fort Pierce, FL 34987 | 2013-01-03 |
| 1780967976 | Mennette J Colon | Specialist/Technologist, Other | 1970 Sw Glendale St., Port Saint Lucie, FL 34987 | 2011-09-23 |
| 1366416257 | Cynthia A Dolan | Dermatology | 10080 Sw Innovation Way Ste 301, Port St Lucie, FL 34987 | 2006-02-15 |
| 1205829074 | Andres M Reyes | Internal Medicine | 10050 Nw Innovation Way, Suite 102, Port St Lucie, FL 34987 | 2005-08-26 |
| 1720498470 | Josue Limage | Family Medicine | 10080 Sw Innovation Way Ste 201, Port St Lucie, FL 34987 | 2014-05-03 |
| Find all providers in zip 34987 | ||||
| Taxonomy Code | 171W00000X |
| Grouping | Other Service Providers |
| Classification | Contractor |
| A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering). |
| Notes: Source: Websters New World Dictionary of the American Language, Second College Edition, William Collins + World Publishing Co., Inc., New York: 1974, p. 308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220297 | Melissa Velez | Contractor | 104 Sw Peacock Blvd Apt 3-205, Port St Lucie, FL 34986-3467 | 2020-09-22 |
| 1063856144 | Jennifer Renae Berrios | Contractor | 271 Sw Sandy Way, Port St Lucie, FL 34986-2082 | 2013-04-19 |
| 1457620171 | Richard Eric Bolander | Contractor | 501 Nw Cashmere Blvd, Port St Lucie, FL 34986-1908 | 2011-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770183683 | Ana Cecilia Fonseca | Contractor | 3456 Sw 112th Ave, Miami, FL 33165-3456 | 2020-10-29 |
| 1477151884 | Joel Laurenceau | Contractor | 2561 Sw Grotto Cir, Port Saint Lucie, FL 34953-2927 | 2020-10-16 |
| 1649878208 | Jill K Bailey | Contractor | 1809 E Broadway St Ste 147, Oviedo, FL 32765-8597 | 2020-10-15 |
| 1700484771 | James Butler | Contractor | 7771 W Oakland Park Blvd Ste 105c, Sunrise, FL 33351-6749 | 2020-10-13 |
| 1407453277 | Princess Laqa Callahan | Contractor | 2620 Nw 19th St, Ft Lauderdale, FL 33311-3324 | 2020-10-05 |
| 1154928158 | Amy Benzenhafer | Contractor | 586 Woodlow Rd, Niceville, FL 32578-2108 | 2020-10-03 |
| 1023623626 | Floridamed Health Network | Contractor | 1806 N Flamingo Rd Ste 220, Pembroke Pines, FL 33028-1030 | 2020-09-10 |
| 1700491677 | Patrice Alicia Leys | Contractor | 2022 Nw 43rd Ter Apt 6, Lauderhill, FL 33313-4340 | 2020-09-09 |
| 1407468366 | Platinum Choice Healthcare | Contractor | 1489 W Palmetto Park Rd Ste 512, Boca Raton, FL 33486-3326 | 2020-08-20 |
| 1992314389 | The Hyer Solution LLC | Contractor | 4461 Barbados Loop, Clermont, FL 34711-5296 | 2020-07-30 |
| Find all providers with the same taxonomy | ||||
| City | PORT ST LUCIE |
| Zip Code | 34987 |
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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.