PUTNAM E N T PA (NPI# 1467648279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467648279 |
| Entity Type | Organization |
| Organization Name | PUTNAM E N T PA |
| Practice Address |
320 Zeagler Dr Ste 1 Palatka FL 32177-6851 |
| Practice Telephone | 3863251565 |
| Practice Fax Number | 3863251571 |
| Mailing Telephone | 3863251565 |
| Mailing Fax Number | 3863251571 |
| Enumeration Date | 2007-09-15 |
| Last Update Date | 2009-04-02 |
| Authorized Official Name | GLENWOOD ANTONIO CHARLES (PRESIDENT) |
| Authorized Official Telephone | 3863251565 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | ME0050554 | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 064059000 | 05 |
| Street Address |
320 ZEAGLER DR STE 1 |
| City | PALATKA |
| State | FL |
| Zip Code | 32177-6851 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013972413 | Dawn Shepherd Miles | Podiatrist | 320 Zeagler Dr, Ste B, Palatka, FL 32177 | 2006-04-19 |
| 1780878413 | Kaushalendra K Singh Md Pa | Internal Medicine | 320 Zeagler Dr, Suite C, Palatka, FL 32177-6851 | 2007-09-06 |
| 1215029731 | Kaushalendra Kumar Singh | Internal Medicine | 320 Zeagler Dr, Suite C, Palatka, FL 32177-6851 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174124176 | Charlie Douglas | Pharmacist | 1024 South State Road 19, Pharmacy, Palatka, FL 32177 | 2020-11-05 |
| 1275090359 | Carol M Kazounis | Dietitian, Registered | 2801 Kennedy Strett, Palatka, FL 32177 | 2019-02-26 |
| 1447744768 | Pulido Internal Medicine | Nurse Practitioner | 700 Zeagler Drive, Suite 1, Palatka, FL 32177 | 2018-06-20 |
| 1063922656 | Ronald Michael Wendt | Nurse Practitioner | 3703 Crill Ave, Palatka, FL 32177 | 2017-10-09 |
| 1043560212 | Leslie Ann Lewis | Massage Therapist | 325 Poinsetta Ave, Palatka, FL 32177 | 2012-09-14 |
| 1285984963 | Walgreens | Pharmacy | 719 South State Road 19, Palatka, FL 32177 | 2012-09-11 |
| 1841549235 | Audrey M Russell | Pharmacy Technician | 719 Hwy 19 South, Palatka, FL 32177 | 2012-08-31 |
| 1194023838 | Sherry D. Michael | Licensed Practical Nurse | 330 Kay Larkin Dr., Palatka, FL 32177 | 2011-03-04 |
| 1083846364 | Patricia Kowalchuk | Occupational Therapy Assistant | 6050 St.johns Ave., Suite A, Palatka, FL 32177 | 2009-08-20 |
| 1609015320 | Robin Calhoun | Occupational Therapist | 611 Zeagler Dr., Palatka, FL 32177 | 2009-02-19 |
| Find all providers in zip 32177 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184804585 | Limeres Medical Clinic Pa | Specialist | 530 Zeagler Dr Ste 102, Palatka, FL 32177-6856 | 2007-11-14 |
| 1467652982 | Florida Therapeutic Massage | Specialist | 108 N 19th St, Palatka, FL 32177-3118 | 2007-07-23 |
| 1053511600 | Sharon Elizabeth Buck | Specialist | 610 S 14th St, Palatka, FL 32177-5018 | 2007-07-23 |
| 1558491670 | Deborah K. Bainbridge | Specialist | 2505 Saint Johns Ave, Palatka, FL 32177-2815 | 2007-03-07 |
| 1205804812 | Putnam Obstetrics and Gynecology Pa | Specialist | 6061 Saint Johns Ave, Suite A, Palatka, FL 32177-6857 | 2006-03-09 |
| 1174521942 | Douglas K Dew M.d. P.a. | Specialist | 6050 Saint Johns Ave, Suite 3, Palatka, FL 32177-6860 | 2005-07-14 |
| 1346647435 | Putnam Neurology Group, Inc. | Specialist | 800 Zeagler Dr, Suite #230, Palatka, FL 32177-3883 | 2014-12-04 |
| 1699964916 | Douglas K Dew | Specialist | 6050 Saint Johns Ave, Sutie 3, Palatka, FL 32177-6860 | 2007-10-23 |
| 1447370002 | Angela Nicole King | Specialist | 120 S Palm Ave, Palatka, FL 32177-4140 | 2007-03-29 |
| 1275589152 | John A Walsh Md Pa | Specialist | 530 Zeagler Dr, Suite A, Palatka, FL 32177-6855 | 2006-05-25 |
| Find all providers in PALATKA | ||||
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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.