DR. JUAN CARLOS FUENTES (NPI# 1487855987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487855987 |
| Entity Type | Individual |
| Full Name | DR. JUAN CARLOS FUENTES |
| Credential | M.D. |
| Practice Address |
559 W Twincourt Trl Unit 601 Credentialing Department St Augustine FL 32095-8805 |
| Mailing Address |
Po Box 45443 Salt Lake City UT 84145-0443 |
| Practice Telephone | 9049401441 |
| Practice Fax Number | 9049401490 |
| Mailing Telephone | 9042021032 |
| Mailing Fax Number | 9043764107 |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2018-12-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME99492 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | P01389011 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184664245 | Juan D Fuentes | Radiology | 5444 Green St, Murray, UT 84123-5632 | 2006-06-07 |
| Street Address |
559 W TWINCOURT TRL UNIT 601 CREDENTIALING DEPARTMENT |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32095-8805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285661736 | Traci L Bragg | Family Medicine | 559 W Twincourt Trl Unit 601, Credentialing Department, St Augustine, FL 32095-8805 | 2006-06-27 |
| 1366861981 | Heather D Nielsen | Family Medicine | 559 W Twincourt Trl Unit 601, St Augustine, FL 32095-8805 | 2014-04-10 |
| 1235353988 | Katherine Ann Wilson | Physician Assistant | 559 W Twincourt Trl Unit 601, St Augustine, FL 32095-8805 | 2007-04-12 |
| 1477635761 | Benjamin D Ernst | Family Medicine | 559 W Twincourt Trl Unit 601, St Augustine, FL 32095-8805 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124299201 | Dental Health Group PC | Dentist | 159 Palencia Village Drive, Ste 109, St. Augustine, FL 32095 | 2008-03-18 |
| 1932259405 | Thomas E Stakem | Dentist | 7175-01 U.S. Highway 17 South, Green Cove Springs, FL 32095 | 2007-01-10 |
| 1942390265 | Antonia Fuller | Registered Nurse | 354 Paseo Reyes Drive, Saint Augustine, FL 32095 | 2006-10-15 |
| 1740223023 | First Choice Phcy Svcs LLC | Pharmacy | 110 Cumberland Dr #305, St Augustine, FL 32095 | 2006-06-14 |
| 1174029201 | Aba Connection, LLC | Early Intervention Provider Agency | 23 Sol Ct, St Augustine, FL 32095 | 2018-04-05 |
| 1457437584 | Stanley A Cohen | Psychiatry & Neurology | 354 Paseo Reyes Drive, St Augustine, FL 32095 | 2006-10-31 |
| 1548576150 | Vicki Glabb | Counselor | 260 Ash Breeze Cv, Saint Augustine, FL 32095-0045 | 2010-08-20 |
| 1245770742 | Linda Gillis | Nurse Practitioner | 143 Portada Dr, St Augustine, FL 32095-1634 | 2017-03-02 |
| 1659821767 | Margo Slovis | Physical Therapist | 244 Vale Dr, St Augustine, FL 32095-4832 | 2016-10-12 |
| 1851909360 | Mammography Partners LLC | Clinic/Center | 521 Costa Del Sol Dr, St Augustine, FL 32095-4868 | 2020-07-21 |
| Find all providers in zip 32095 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679172779 | Flagler Family Nursing Home Care LLC | Family Medicine | 130 Healthpark Blvd, St Augustine, FL 32086-5776 | 2020-10-20 |
| 1023467347 | Marylin Palackel James | Family Medicine | 110 Hampton Point Dr, St Augustine, FL 32092 | 2016-06-07 |
| 1821406679 | Flagler Family Medicine Pa | Family Medicine | 315 W Town Pl Ste 1, St Augustine, FL 32092-3105 | 2014-07-24 |
| 1114351079 | Vip Doctors Care of St Augustine LLC | Family Medicine | 655 State Road 207, Suite 102, St Augustine, FL 32084-5937 | 2013-08-28 |
| 1205085107 | Imran Hyderali Rajwani | Family Medicine | 309 Kingsley Lake Dr, Suite No. 904, St Augustine, FL 32092-3047 | 2008-09-16 |
| 1851463731 | Dudley Atkin Baringer | Family Medicine | 120 Health Park Blvd, Suite 1, St Augustine, FL 32086-3701 | 2006-11-15 |
| 1932215571 | Anastasia Family and Urgent Care | Family Medicine | 103 Anastasia Blvd, St Augustine, FL 32080-4503 | 2006-08-23 |
| 1649383845 | Roy H Hinman Md Pa | Family Medicine | 100 Arricola Avenue, St Augustine, FL 32080-4515 | 2006-08-15 |
| 1710090915 | Daniel J Donofrio | Family Medicine | 1099 A1a Beach Blvd, St Augustine, FL 32080 | 2006-08-15 |
| 1225051238 | Zehra Cumber | Family Medicine | 1955 Us 1 S Ste 100, St Augustine, FL 32086-5788 | 2006-07-25 |
| Find all providers in ST AUGUSTINE | ||||
| City | ST AUGUSTINE |
| Zip Code | 32095 |
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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.