LINDSEY NICOLE BROADNAX (NPI# 1477830909) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1477830909 |
Entity Type | Individual |
Full Name | LINDSEY NICOLE BROADNAX |
Credential | PA |
Practice Address |
16646 N Dale Mabry Hwy Tampa FL 33618-1400 |
Mailing Address |
655 7th St Bldg 700 78 Mdg/sgohf Warner Robins GA 31098-2227 |
Practice Telephone | 4783278040 |
Mailing Telephone | 4783278040 |
Enumeration Date | 2011-11-11 |
Last Update Date | 2019-04-17 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9109608 | FL | Physician Assistants & Advanced Practice Nursing Providers |
N | 363AM0700X |
Physician Assistant Specialization: Medical |
006840 | GA | Physician Assistants & Advanced Practice Nursing Providers |
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9106238 | FL | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
16646 N DALE MABRY HWY |
City | TAMPA |
State | FL |
Zip Code | 33618-1400 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265520662 | Marty Wayne Odom | Internal Medicine | 16646 N Dale Mabry Hwy, Tampa, FL 33618-1400 | 2006-10-11 |
1528621885 | Tina Agostinelli | Physician Assistant | 16646 N Dale Mabry Hwy, Tampa, FL 33618-1400 | 2019-04-22 |
1114493889 | Alexis Prickett Adams | Physician Assistant | 16646 N Dale Mabry Hwy, Tampa, FL 33618-1400 | 2018-10-19 |
1154767960 | Caitlin Odom | Physician Assistant | 16646 N Dale Mabry Hwy, Tampa, FL 33618-1400 | 2013-05-20 |
1396949293 | Citrus Park Internal Medicine | Clinic/Center | 16646 N Dale Mabry Hwy, Tampa, FL 33618-1400 | 2007-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730714130 | Virgin Mary's Pharmacy | Pharmacy | 14606 N Dale Mabry, Tampa, FL 33618 | 2020-03-05 |
1801378252 | Leah Rae Petit | Nurse Practitioner | 3505, 11809 N Dale Mabry Hwy, Tampa, FL 33618 | 2018-09-02 |
1265921100 | Almighty Home Healthcare Services, Inc. | Home Health | 16614 N. Dale Mabry Hwy, Tampa, FL 33618 | 2018-05-07 |
1972016368 | Pepe C Mcneal | Specialist | 15241 North Dalemabry Ave, Sola Salons (studio #14, Tampa, FL 33618 | 2017-11-08 |
1760919179 | Sara Ashley Carr | Counselor | 10014 N Dale Mabry Hwy Ste 216, Tampa, FL 33618 | 2017-05-16 |
1073975231 | National Vision, Inc. | Technician/Technologist | 10934 N Dale Mabry Hwy, Carrollwood, FL 33618 | 2016-03-25 |
1003209792 | Tampa General Medical Group Inc | Internal Medicine | 3419 N Lakeview Dr, Tampa, FL 33618 | 2015-03-05 |
1114205648 | Liberty Medical Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3653 Madaca Ln, Tampa, FL 33618 | 2011-08-02 |
1386938215 | David Leonardo Higuera | Pharmacist | 2901 W Bush Blvd, Suite 104, Tampa, FL 33618 | 2011-06-08 |
1922303973 | Kimberly Lynne Little | Social Worker | 3044 W. Bearss Avenue, Tampa, FL 33618 | 2011-01-24 |
Find all providers in zip 33618 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336762046 | Samantha Martin | Physician Assistant | 12950 Race Track Rd Ste 106, Tampa, FL 33626-1304 | 2020-05-28 |
1124648159 | Christian Otero | Physician Assistant | 311 W Palm Ave, Tampa, FL 33602-2029 | 2020-04-20 |
1487219036 | Vanessa Natasha White | Physician Assistant | 10205 W Hillsborough Ave Ste B, Tampa, FL 33615-3671 | 2019-05-08 |
1518520873 | Zachary Luke Ulshafer | Physician Assistant | 12901 Bruce B Downs Blvd # 05, Tampa, FL 33612-4742 | 2019-04-22 |
1548756893 | Christopher Jacob Bordelon | Physician Assistant | 2550 W Dr Martin Luther King Jr Blvd Ste B, Tampa, FL 33607-6302 | 2018-07-10 |
1871033340 | Amanda Lins Chissell | Physician Assistant | 13801 Bruce B Downs Blvd Ste 231, Tampa, FL 33613-3946 | 2017-03-03 |
1669839767 | Barbara N Vargas | Physician Assistant | 12500 N Dale Mabry Hwy Ste A, Tampa, FL 33618-2809 | 2016-01-20 |
1215305776 | Amber Lubas | Physician Assistant | 401 N Rome Ave, Apt: 4314, Tampa, FL 33606-0009 | 2015-09-14 |
1972988467 | Karla Michelle Mincone | Physician Assistant | 3040 W Cypress St # 103, Tampa, FL 33609-1615 | 2015-07-25 |
1326441767 | Brigett Brandjes | Physician Assistant | 2902 Usf Magnolia Drive, Tampa, FL 33612 | 2014-09-30 |
Find all providers in TAMPA |
Please comment or provide details below to improve the information on LINDSEY NICOLE BROADNAX.
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.