SHORESIDE MEDICAL CENTER LLC (NPI# 1518371996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518371996 |
| Entity Type | Organization |
| Organization Name | SHORESIDE MEDICAL CENTER LLC |
| Practice Address |
419 East Third Ave New Smyrna Beach FL 32169 |
| Mailing Address |
449 Rockefeller Dr New Smyrna FL 32168-8937 |
| Practice Telephone | 3869573800 |
| Practice Fax Number | 3864265939 |
| Mailing Telephone | 3869573800 |
| Mailing Fax Number | 3864265939 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |
| Authorized Official Name | MS. TRACI LW POSTELL (CEO) |
| Authorized Official Telephone | 3863164111 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | OS8699 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
419 EAST THIRD AVE |
| City | NEW SMYRNA BEACH |
| State | FL |
| Zip Code | 32169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730604687 | Kristopher Allen Kessler | Chiropractor | 701 E 3rd Ave Unit 5, New Smyrna Beach, FL 32169 | 2017-08-11 |
| 1326420449 | Hugh Jacob Flanagan | Pharmacist | 709 E. 3rd Ave., New Smyrna Beach, FL 32169 | 2015-06-25 |
| 1447692272 | Donald B Walsh | Massage Therapist | 259 N Causeway, New Smyrna, FL 32169 | 2013-07-22 |
| 1841572047 | John A Stamm Jr. | Pharmacist | 800 Hwy A1a, New Smyrna Beach, FL 32169 | 2011-09-13 |
| 1578845764 | Benjamin Hanna | Pharmacist | 800 State Hwy A1a, New Smyrna Beach, FL 32169 | 2011-09-13 |
| 1669794681 | Health Point Pllc | Acupuncturist | 394-b North Causeway, New Smyrna Beach, FL 32169 | 2010-02-17 |
| 1831388917 | Evan D Magee | Specialist | 221 Robinson Rd, New Smyrna Bch, FL 32169 | 2007-10-15 |
| 1538376629 | Cathy Elizabeth Harris | Acupuncturist | 221 North Causeway, Suite C, New Smyrna Beach, FL 32169 | 2007-05-17 |
| 1770700106 | Andrea J Robins | Mechanotherapist | 101 Cedar Dunes Drive, New Smyrna Beach, FL 32169 | 2007-04-19 |
| 1376550046 | Kwang Joon Choi | Pediatrics | 245 N Causeway, New Smyrna Beach, FL 32169 | 2006-08-02 |
| Find all providers in zip 32169 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083998090 | Gary E Morales Geraldino | General Practice | 2700 N Peninsula Ave Apt 516, New Smyrna Beach, FL 32169-2074 | 2011-10-10 |
| 1023207016 | James R Meredith | General Practice | 502 Palmetto St, New Smyrna Beach, FL 32168-7325 | 2007-10-16 |
| 1568451318 | James Wes Tanner | General Practice | 1722 State Road 44, New Smyrna Beach, FL 32168-8339 | 2005-10-14 |
| 1962844381 | Mhc Holdings Inc. | General Practice | 902 N Dixie Fwy, New Smyrna Beach, FL 32168-6220 | 2013-07-26 |
| 1770747990 | Medical Holistic Center, LLC | General Practice | 512 Canal St, New Smyrna Beach, FL 32168-7012 | 2008-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265033823 | Bless Medical Center of Nmb LLC | General Practice | 1400 Ne Miami Gardens Dr Ste 209, North Miami Beach, FL 33179-4844 | 2020-11-02 |
| 1982203634 | Central Florida Wellness LLC | General Practice | 15516 W Colonial Dr Ste 111, Winter Garden, FL 34787-9558 | 2020-10-23 |
| 1760080212 | Summit Health Multi Specialty of Florida LLC | General Practice | 1881 W Kennedy Blvd Ste D, Tampa, FL 33606-1611 | 2020-10-15 |
| 1376140772 | Amy Wrenn | General Practice | 155 Cranes Roost Blvd Ste 2020-a, Altamonte Springs, FL 32701-3468 | 2020-10-08 |
| 1992302574 | Avita Medical Clinic, LLC | General Practice | 14831 N Florida Ave, Tampa, FL 33613-1825 | 2020-10-06 |
| 1568069672 | Ernesto Oscar Gonzalez Pupo | General Practice | 14420 Sw 22nd St, Miami, FL 33175-6338 | 2020-10-02 |
| 1508463779 | Ashley Zanders Walton | General Practice | 75 Foxfire Ct, Quincy, FL 32351-7293 | 2020-10-01 |
| 1730796830 | Brid M Wade | General Practice | 3199 Cornell Dr, Gulf Breeze, FL 32563-2785 | 2020-09-23 |
| 1902412786 | New Era Medical Pllc | General Practice | 628 Cleveland St Ste A, Clearwater, FL 33755-6603 | 2020-09-17 |
| 1417562414 | Jl Laria Aprn Pa | General Practice | 5751a Sw 40th St, Miami, FL 33155-5301 | 2020-09-15 |
| Find all providers with the same taxonomy | ||||
| City | NEW SMYRNA BEACH |
| Zip Code | 32169 |
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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.