DAVID M GONDEK (NPI# 1487684528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487684528 |
| Entity Type | Individual |
| Full Name | DAVID M GONDEK |
| Credential | PA-C |
| Practice Address |
180 Jfk Dr Ste 100 Atlantis FL 33462 |
| Mailing Address |
180 Jfk Dr Ste 100 Atlantis FL 33462-6641 |
| Practice Telephone | 5619676500 |
| Practice Fax Number | 5614334175 |
| Mailing Telephone | 5619676500 |
| Mailing Fax Number | 5614334175 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2019-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA1860 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 1860 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA1860 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 019839000 | 05 | |
| FL | DEA | MG5012707 | 01 |
| FL | PA LICENSE | PA1860 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2222 S Harbor City Blvd Ste 100, Melbourne, FL 329015594 | 3217237716 | 3217230604 |
| 709 S Harbor City Blvd Ste 100, Melbourne, FL 329011936 | 3217252225 | 3213080635 |
| 8005 Bay St Ste 5, Sebastian, FL 329583244 | 3217237716 | 3217230604 |
| 10275 Hagen Ranch Rd Ste 200, Boynton Beach, FL 334373784 | 5619676500 | 5614334175 |
| 1221 S State Road 7 Ste 200, Wellington, FL 334146212 | 5619676500 | 5614334175 |
| Street Address |
180 JFK DR STE 100 |
| City | ATLANTIS |
| State | FL |
| Zip Code | 33462 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164476701 | Charles W Graubert | Physical Medicine & Rehabilitation | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2006-05-19 |
| 1760027791 | Nicholas Morgan | Physician Assistant | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2019-11-13 |
| 1720490105 | Brandon Shallop | Orthopaedic Surgery | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2014-05-20 |
| 1881957868 | Joseph Alexis Quinones | Anesthesiology | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2012-06-24 |
| 1598031536 | Brittany Quinn Ester | Occupational Therapy Assistant | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2012-03-23 |
| 1649571498 | Joseph W Foldessy | Physician Assistant | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2010-11-10 |
| 1205008109 | Jason Billinghurst | Orthopaedic Surgery | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2008-03-31 |
| 1104009067 | Ezra A Berkowitz | Orthopaedic Surgery | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2007-12-13 |
| 1437349248 | Michael Alan Cohn | Orthopaedic Surgery | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2007-07-27 |
| 1609075316 | Sue Shin Cohn | Anesthesiology | 180 Jfk Dr Ste 100, Atlantis, FL 33462-6641 | 2007-07-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104449503 | Brightlife Institute, LLC | Clinic/Center | 2315 Shimmery Lane, Lake Worth, FL 33462 | 2020-05-20 |
| 1760024988 | Woodelyne Marc | Home Health | 1307 Flamingo Dr, Lantan, FL 33462 | 2019-10-09 |
| 1336624428 | Jennifer Lynn Jones | Nurse Practitioner | 5401 S Congress Ave Ste 105, Atlantis, FL 33462 | 2018-09-25 |
| 1427548445 | Publix Super Markets, Inc. | Pharmacy | 262 S Ocean Blvd, Manalapan, FL 33462 | 2018-05-15 |
| 1629567474 | Perfection Rx LLC | Pharmacy | 3248 Lantana Rd, Lake Worth, FL 33462 | 2018-05-08 |
| 1942797824 | Mayra Alejandra Tovar Castro | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-17 |
| 1285131169 | Samar Ibrahim Mohamed Huss Aboulenain | Student in an Organized Health Care Education/Training Program | 180 Jfk Drive, Suite 210, Atlantis, FL 33462 | 2018-04-09 |
| 1801392535 | Carla Ortega | Student in an Organized Health Care Education/Training Program | 180 Jkf Drive, Suite 210, Atlantis, FL 33462 | 2018-04-02 |
| 1811427438 | Sonia Camille | Behavior Technician | 49 Sioux Ln, Lantana, FL 33462 | 2017-06-15 |
| 1922536648 | Alyzza De La Uz Forte | Nurse Practitioner | 180 John F Kennedy Dr, 311, Atlantis, FL 33462 | 2017-05-25 |
| Find all providers in zip 33462 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285701060 | Sheree Waterous | Physician Assistant | 205 Jfk Dr, Suite A, Atlantis, FL 33462-1151 | 2006-11-29 |
| 1043325673 | Michelle Barletta | Physician Assistant | 5301 S Congress Ave, Rothman Center, 4th Floor, Atlantis, FL 33462-1149 | 2006-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255931325 | Jonathan Thomas Nusbaum | Physician Assistant | 26160 Angelica Rd, Punta Gorda, FL 33955-1419 | 2020-10-28 |
| 1235738659 | Kevin Marcus Luks | Physician Assistant | 10701 Santa Fe Dr, Hollywood, FL 33026-4955 | 2020-10-19 |
| 1245839521 | Stephanie Clay | Physician Assistant | 3455 Rose Mallow Loop, Oviedo, FL 32766-6648 | 2020-10-19 |
| 1104423755 | Lou Joseph Schneggenburger | Physician Assistant | 10115 Forest Hill Blvd Ste 100, Wellington, FL 33414-6178 | 2020-10-07 |
| 1235744582 | Stephanie Graham | Physician Assistant | 1053 Bernice Rd, Rockledge, FL 32955-2201 | 2020-09-14 |
| 1790399483 | Shyla Imani Kissoon | Physician Assistant | 4830 Nw 7th St, Plantation, FL 33317-1410 | 2020-09-01 |
| 1770193500 | My Physician Online | Physician Assistant | 9540 Nw 23rd St, Coral Springs, FL 33065-4974 | 2020-08-06 |
| 1225647977 | Robert Drew Singleton | Physician Assistant | 17501 Biscayne Blvd Ste 460, Aventura, FL 33160-4806 | 2020-07-29 |
| 1750990974 | Andrea K Webber | Physician Assistant | 8119 Sw State Rd 200, Ocala, FL 34481-3448 | 2020-07-23 |
| 1851919526 | Kyra Panni | Physician Assistant | 3857 Hartwood Ln, Jacksonville, FL 32216-1486 | 2020-07-09 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DAVID M GONDEK.
| 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.