BAPTIST - SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES, INC. (NPI# 1538593124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538593124 |
| Entity Type | Organization |
| Organization Name | BAPTIST - SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES, INC. |
| Other Organization Name | BAPTIST MD ANDERSON CANCER PHYSICIANS |
| Practice Address |
1235 San Marco Blvd Suite 2 Jacksonville FL 32207-8554 |
| Mailing Address |
1235 San Marco Blvd 4th Floor Administration Jacksonville FL 32207 |
| Practice Telephone | 9042027300 |
| Practice Fax Number | 9042027377 |
| Mailing Telephone | 9042025028 |
| Mailing Fax Number | 9043915167 |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2018-10-11 |
| Authorized Official Name | LEEANN MENGEL (ADMINISTRATOR) |
| Authorized Official Telephone | 9043763707 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
FL | Allopathic & Osteopathic Physicians | |
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
FL | Allopathic & Osteopathic Physicians | |
| N | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
FL | Allopathic & Osteopathic Physicians | |
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
FL | Allopathic & Osteopathic Physicians | |
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
FL | Allopathic & Osteopathic Physicians | |
| N | 2085R0001X |
Radiology Specialization: Radiation Oncology |
FL | Allopathic & Osteopathic Physicians | |
| N | 2086X0206X |
Surgery Specialization: Surgical Oncology |
FL | Allopathic & Osteopathic Physicians | |
| N | 208800000X | Urology | FL | Allopathic & Osteopathic Physicians | |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | FL | Allopathic & Osteopathic Physicians | |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 0099422-00 | 05 | |
| FL | RAILROAD MEDICARE | DU3570 | 01 |
| GA | 003149978A | 05 | |
| FL | 009942201 | 05 |
| Other Name | Type Code |
|---|---|
| Baptist MD Anderson Cancer Physicians | Doing Business As Name - Organization |
| Street Address |
1235 SAN MARCO BLVD SUITE 2 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32207-8554 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699762906 | Robert Allen Joyce | Internal Medicine | 1235 San Marco Blvd, 3rd Floor, Jacksonville, FL 32207 | 2005-10-03 |
| 1962862466 | Stephanie Palazzolo | Physician Assistant | 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 | 2016-02-26 |
| 1609286897 | Baptist-southeast Gynecologic Oncology Inc | Radiology | 1235 San Marco Blvd, Suite 1, Jacksonville, FL 32207-8554 | 2014-04-28 |
| 1548512056 | Cancer Specialists LLC | Durable Medical Equipment & Medical Supplies | 1235 San Marco Blvd, Suite 202, Jacksonville, FL 32207-8554 | 2012-10-08 |
| 1871849034 | Melinda Wheeley Fawbush | Nurse Practitioner | 1235 San Marco Blvd, #419, Jacksonville, FL 32207-8554 | 2012-07-25 |
| 1215101902 | 21st Century Oncology of Jacksonville LLC | Surgery | 1235 San Marco Blvd, Suite 3, Jacksonville, FL 32207-8554 | 2008-04-15 |
| 1437331733 | Nicole Sunderland Anderson | Radiology | 1235 San Marco Blvd, Suite 100, Jacksonville, FL 32207-8554 | 2007-11-29 |
| 1497956072 | John Ho Vu | Internal Medicine | 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 | 2007-05-30 |
| 1477605962 | Gerard A Coluccelli Md Pa | Ophthalmology | 1235 San Marco Blvd, 401, Jacksonville, FL 32207 | 2007-01-17 |
| 1427109248 | Seth A Strope | Urology | 1235 San Marco Blvd, Suite 2, Jacksonville, FL 32207-8554 | 2007-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
| 1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
| 1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
| 1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
| 1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
| 1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
| 1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
| 1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
| 1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
| 1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
| Find all providers in zip 32207 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760818959 | Talha Badar | Internal Medicine | 4500 San Pablo Rd S # X, Jacksonville, FL 32224-1865 | 2013-09-19 |
| 1952621237 | Harvey B Sher | Internal Medicine | 2742 Beauclerc Rd, Jacksonville, FL 32257-5602 | 2010-06-09 |
| 1548426703 | Ewa M Wysokinska | Internal Medicine | 4500 San Pablo Rd S Fl 3222, Jacksonville, FL 32224-1865 | 2008-08-06 |
| 1750598363 | Sridhar Srinivasan | Internal Medicine | 14546 Old Saint Augustine Rd Ste 100, Jacksonville, FL 32258-5468 | 2007-05-16 |
| 1891878146 | Miten R Patel | Internal Medicine | 7015 Ac Skinner Parkway, Building 100, Jacksonville, FLORIDA 32256-6932 | 2006-10-23 |
| 1831122035 | Shonda Michelle Asaad | Internal Medicine | 239 Station St, Jacksonville, NC 28546-6304 | 2006-07-09 |
| 1770535700 | Sahana R Kalmadi | Internal Medicine | 14546 Old Saint Augustine Rd Ste 317, Jacksonville, FL 32258-5472 | 2006-05-17 |
| 1902889959 | Maria J Valente | Internal Medicine | 7015 A C Skinner Pkwy, Bldg 100, Jacksonville, FL 32256-6932 | 2005-11-23 |
| 1124017850 | Lawrence Arthur Solberg Jr. | Internal Medicine | 3827 Coopers Lake Rd, Jacksonville, FL 32224-8436 | 2005-10-15 |
| 1922095884 | Carlos M Castillo | Internal Medicine | 7751 Baymeadows Rd E Ste 205, Jacksonville, FL 32256 | 2005-10-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32207 |
Please comment or provide details below to improve the information on BAPTIST - SOUTHEAST GYNECOLOGIC ONCOLOGY ASSOCIATES, INC..
| 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.