KIDS HEALTH ALLIANCE PA (NPI# 1467619676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467619676 |
| Entity Type | Organization |
| Organization Name | KIDS HEALTH ALLIANCE PA |
| Practice Address |
2650 Nw 2nd St Suite 100 Ocala FL 34475-6234 |
| Practice Telephone | 3522375400 |
| Practice Fax Number | 8662605182 |
| Mailing Telephone | 3522375400 |
| Mailing Fax Number | 8662605182 |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2019-02-25 |
| Authorized Official Name | DR. SHAHAB EUNUS (CEO/MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3525982479 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 023548300 | 05 | |
| PTAN | 103933 | 01 |
| Street Address |
2650 NW 2ND ST SUITE 100 |
| City | OCALA |
| State | FL |
| Zip Code | 34475-6234 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154338952 | Allyson Casey | Nurse Practitioner | 2650 Nw 2nd St, Suite 100, Ocala, FL 34475-6234 | 2006-08-02 |
| 1134487903 | Mamatha Sandu | Pediatrics | 2650 Nw 2nd St, Suite 100, Ocala, FL 34475-6234 | 2012-04-30 |
| 1124263496 | Donald John Conner Jr. | Nurse Practitioner | 2650 Nw 2nd St, Ocala, FL 34475-6234 | 2008-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508342122 | Gallo Enterprises | Non-emergency Medical Transport (VAN) | 3951 Nw Blitchton Road, Ocala, FL 34475 | 2018-07-17 |
| 1376059642 | Samantha Denise Gray | Behavior Technician | 3856 W Anthony Rd, Ocala, FL 34475 | 2017-12-21 |
| 1487160008 | Leslie Grace Hemp | Behavior Technician | 3856 West Anthony Rd, Ocala, FL 34475 | 2017-12-19 |
| 1154855005 | Homehealth | Home Health | 1717 Nw Pine Avenue, Ocala, FL 34475 | 2017-04-18 |
| 1356883672 | Fifth Circuit Pulic Guardian Corp. | Case Management | 110 Nw 1st St, Courthouse, Ocala, FL 34475 | 2016-11-17 |
| 1003295940 | Open Arms | Home Health Aide | 6775 Nw 6th Ave, Ocala, FL 34475 | 2015-05-26 |
| 1902206121 | Jessica Beylotte | Home Health | 100 Nw 23rd Ave Apt 1101, Ocala, FL 34475 | 2014-08-25 |
| 1306101472 | Shywhann Denise Gray | Licensed Practical Nurse | 2418nw 18th St., Ocala, FL 34475 | 2012-07-05 |
| 1831327162 | Wendy Dawn Sprouse | Counselor | 717 Martin Luther King Jr Avenue, Ocala, FL 34475 | 2009-06-25 |
| 1083835128 | Leslie Therese Shutack | Physical Therapy Assistant | 6658 Nw 4th Ave, Ocala, FL 34475 | 2007-05-02 |
| Find all providers in zip 34475 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548400633 | Premier Pediatrics LLC | Clinic/Center | 7960 Sw 60th Ave, Ocala, FL 34476-6457 | 2009-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952917015 | Bonifay Rural Health Cinic | Clinic/Center | 2910 Hospital Dr Ste A, Bonifay, FL 32425-4268 | 2020-09-23 |
| 1013540947 | Clark Clinic Inc | Clinic/Center | 12620 Curley St, San Antonio, FL 33576-8136 | 2020-02-19 |
| 1023506532 | Sacred Heart Hospital On The Gulf | Clinic/Center | 805 Highway 22, Wewahitchka, FL 32465-3237 | 2018-04-30 |
| 1639693492 | Clark Clinic Inc | Clinic/Center | 910 W Myers Blvd, Mascotte, FL 34753-9748 | 2017-08-02 |
| 1194173419 | Holmes County Hospital Corporation | Clinic/Center | 5556 Brown St, Graceville, FL 32440-1007 | 2016-05-26 |
| 1568826873 | Healthvine Medical Group Inc | Clinic/Center | 725 Benton Ave, Brooksville, FL 34601-3213 | 2016-04-12 |
| 1164808465 | Family and After Hours Care, LLC | Clinic/Center | 1413 Nw 23rd Ave, Chiefland, FL 32626 | 2015-08-10 |
| 1891171914 | High Springs Pediatrics LLC. | Clinic/Center | 14900 Nw 140th St, Alachua, FL 32615-6276 | 2015-07-31 |
| 1982963344 | Sacred Heart Hospital On The Gulf | Clinic/Center | 55 Avenue 'e', Apalachicola, FL 32320-1763 | 2012-05-04 |
| 1760776900 | Sonnis Pediatrics, Inc. | Clinic/Center | 1125 S 6th Ave, Wauchula, FL 33873-3350 | 2011-06-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on KIDS HEALTH ALLIANCE PA.
| 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.