FIRST COAST CARDIOVASCULAR (NPI# 1467986737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467986737 |
| Entity Type | Organization |
| Organization Name | FIRST COAST CARDIOVASCULAR |
| Practice Address |
725 S 6th St Macclenny FL 32063-9653 |
| Mailing Address |
Po Box 551308 Jacksonville FL 32255-1308 |
| Practice Telephone | 9044933333 |
| Practice Fax Number | 9044932222 |
| Mailing Telephone | 9044933333 |
| Mailing Fax Number | 9044932222 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2017-04-13 |
| Authorized Official Name | DR. YAZAN KHATIB (PRESIDENT) |
| Authorized Official Telephone | 9044933333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265973911 | First Coast Cardiovascular | Internal Medicine | 205 Zeagler Dr, Palatka, FL 32177-3888 | 2017-03-14 |
| 1790226447 | First Coast Cardiovascular | Internal Medicine | 5233 Ricker Rd, Suite 101, Jacksonville, FL 32210-1438 | 2017-03-14 |
| 1083155725 | First Coast Cardiovascular | Internal Medicine | 3890 Dunn Ave, Ste 203, Jacksonville, FL 32218-6428 | 2017-03-14 |
| 1811438559 | First Coast Cardiovascular | Internal Medicine | 9759 San Jose Blvd, Ste 2, Jacksonville, FL 32257-4401 | 2017-03-14 |
| 1659812394 | First Coast Cardiovascular | Internal Medicine | 665 State Road 207, Suite 102, St Augustine, FL 32084-5938 | 2017-03-14 |
| 1255872982 | First Coast Cardiovascular | Internal Medicine | 1681 Eagle Harbor Pkwy, Ste B, Fleming Island, FL 32003-4819 | 2017-03-14 |
| 1154862803 | First Coast Cardiovascular | Internal Medicine | 1201 Monument Rd, Suite 201b, Jacksonville, FL 32225-7411 | 2017-03-14 |
| Street Address |
725 S 6TH ST |
| City | MACCLENNY |
| State | FL |
| Zip Code | 32063-9653 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144283219 | Angelito B Tecson | Family Medicine | 725 S 6th St, Macclenny, FL 32063 | 2006-04-10 |
| 1578028478 | Kassie Crews Shoup | Nurse Practitioner | 725 S 6th St, Macclenny, FL 32063-9653 | 2019-02-05 |
| 1659770121 | Whitney Renae Nimmo-olsen | Nurse Practitioner | 725 S 6th St, Macclenny, FL 32063-9653 | 2014-08-20 |
| 1205097060 | Tecson Family Practice Inc | Family Medicine | 725 S 6th St, Maccle, Macclenny, FL 32063 | 2008-06-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578164976 | Justin Gary Dugger | Pharmacist | 9218 Sr-228 E, Macclenny, FL 32063 | 2020-11-03 |
| 1285175091 | Katie Rourke | Massage Therapist | 6068 -1 Larimer Rd, Macclenny, FL 32063 | 2017-03-13 |
| 1174734073 | Jane Ellen Echterling | Psychologist | Northeast Florida State Hospital, 7487 S. State Road 121, Macclenny, FL 32063 | 2007-05-24 |
| 1992879886 | Baker County Schools | Local Education Agency (LEA) | 290 Jonathan St E, Macclenny, FL 32063 | 2006-11-20 |
| 1306918271 | Baker County School Board | Local Education Agency (LEA) | 290 Jonathan Street East, Macclenny, FL 32063 | 2006-11-15 |
| 1780760967 | Patricia Ann Sova | Pharmacist | 1436 Sw 6th St, Winn Dixie #0144, Macclenny, FL 32063 | 2006-10-31 |
| 1447347992 | Annie Clara Widemond | Pharmacy Technician | 1436 State Road 121 South, Macclenny, FL 32063 | 2006-10-06 |
| 1003900713 | Luna S. Iskander | Psychiatry & Neurology | 7487 South State Road 121, Macclenny, FL 32063 | 2006-10-03 |
| 1558456103 | Cam Hoang | Family Medicine | 7487 South State Road 171, Macclenny, FL 32063 | 2006-10-03 |
| 1245323492 | Raynors Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 698 F W Macclenny Ave, Ste F, Macclenny, FL 32063 | 2006-10-02 |
| Find all providers in zip 32063 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1437765443 | Premier Cardiovascular Center, LLC | Internal Medicine | 450 W State Road 434 Ste 2010, Longwood, FL 32750-5187 | 2020-09-16 |
| 1679199236 | Tallahassee Memorial Healthcare Inc | Internal Medicine | 877 3rd St Ste 3, Chipley, FL 32428-1855 | 2020-06-19 |
| 1972123701 | Heart Clinic of Central Florida LLC | Internal Medicine | 52 Riley Rd # 429, Celebration, FL 34747-5420 | 2020-04-22 |
| 1205465440 | Cardiology Group Panel LLC | Internal Medicine | 201 Nw 82nd Ave Ste 405, Plantation, FL 33324-1883 | 2020-04-08 |
| 1346876745 | H & D Cardiology, Pa | Internal Medicine | 1879 Nightingale Ln Ste B2, Tavares, FL 32778-4363 | 2020-03-17 |
| 1427690775 | The Cardiac and Vascular Institute Ambulatory Surgery Center | Internal Medicine | 4645 Nw 8th Ave Ste 10, Gainesville, FL 32605-4688 | 2019-10-08 |
| 1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
| 1023660255 | Florida Medical Specialists LLC | Internal Medicine | 1250 S Tamiami Trl Ste 300, Sarasota, FL 34239-2221 | 2019-07-09 |
| 1962064493 | Ckk Medical LLC | Internal Medicine | 6600 Sw State Road 200 # 200, Ocala, FL 34476-5554 | 2019-07-04 |
| 1952968026 | Jose Miguel Simo | Internal Medicine | 3347 S State Road 7 Ste 205, Wellington, FL 33449-8148 | 2019-05-23 |
| Find all providers with the same taxonomy | ||||
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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.