PAUL DOUGLAS (NPI# 1528605623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528605623 |
| Entity Type | Individual |
| Full Name | PAUL DOUGLAS |
| Practice Address |
3811 Clyde Morris Blvd Port Orange FL 32129-2306 |
| Mailing Address |
214 Sand Pebble Cir Port Orange FL 32129-3630 |
| Practice Telephone | 3862816889 |
| Practice Fax Number | 3862816888 |
| Mailing Telephone | 3863419197 |
| Enumeration Date | 2019-12-08 |
| Last Update Date | 2019-12-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PS18285 | FL | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568474518 | Paul K Douglas | Optometrist | 1205 N Michigan Ave, Saginaw, MI 48602-4729 | 2006-08-11 |
| 1225096415 | Paul Dean Douglas | Dentist | 10630 N Scottsdale Rd, Scottsdale, AZ 85254 | 2006-05-04 |
| 1861427163 | Paul L. Douglas | Radiology | 2320 Bath St, Suite 208, Santa Barbara, CA 93105-4339 | 2006-07-12 |
| Street Address |
3811 CLYDE MORRIS BLVD |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-2306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922456128 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 3811 Clyde Morris Blvd, Port Orange, FL 32129-2306 | 2016-05-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184246357 | Mariana Attalla | Pharmacist | 6095 Pheasant Ridge Dr, Port Orange, FL 32128-6986 | 2020-05-11 |
| 1063033934 | Ploumi Cain | Pharmacist | 1418 New Bolton Dr, Port Orange, FL 32129-5316 | 2020-05-02 |
| 1326412842 | Jeffry A Szymczak | Pharmacist | 3296 Spruce Creek Gln, Port Orange, FL 32128-6867 | 2015-11-20 |
| 1649608688 | Lisa St. Louis | Pharmacist | 4036 S Nova Rd, Port Orange, FL 32127-9276 | 2013-10-30 |
| 1144661554 | Susan Kay Dembinsky | Pharmacist | 748 Renegade Ln, Port Orange, FL 32127-7586 | 2013-07-13 |
| 1023263381 | Atlantic Medication Management Systems Inc | Pharmacist | 1545 Town Park Dr, Port Orange, FL 32129-5274 | 2008-11-28 |
| 1992993083 | Benjamin Spitz | Pharmacist | 489 Oakland Park Blvd, Port Orange, FL 32127-9538 | 2007-10-15 |
| 1396806568 | Eugene A Coe | Pharmacist | 4007 S Nova Rd, Port Orange, FL 32127-4922 | 2006-12-12 |
| 1912507377 | Mathew Shaw | Pharmacist | 1590 Dunlawton Ave, Port Orange, FL 32127-4752 | 2020-10-27 |
| 1932713872 | Vita Makar | Pharmacist | 3830 S Nova Rd Ste C4, Port Orange, FL 32127-9205 | 2020-09-08 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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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.