SOUTHEAST ORTHOPEDIC SPECIALISTS, INC (NPI# 1548681109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548681109 |
| Entity Type | Organization |
| Organization Name | SOUTHEAST ORTHOPEDIC SPECIALISTS, INC |
| Practice Address |
232 Ponte Vedra Park Dr Ponte Vedra Beach FL 32082-6600 |
| Mailing Address |
6500 Bowden Rd Suite 103 Jacksonville FL 32216-8070 |
| Practice Telephone | 9046340640 |
| Practice Fax Number | 9046340203 |
| Mailing Telephone | 9046340640 |
| Mailing Fax Number | 9046746155 |
| Enumeration Date | 2013-12-30 |
| Last Update Date | 2018-09-27 |
| Authorized Official Name | JANET N JAGUNIC (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 9046340640 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972969756 | Southeast Orthopedic Specialists, Inc | Non-Pharmacy Dispensing Site | 2627 Riverside Ave, Suite 300, Jacksonville, FL 32204-4712 | 2016-01-08 |
| 1003244658 | Southeast Orthopedic Specialists, Inc | Physical Therapist | 2627 Riverside Ave, 3rd Floor, Jacksonville, FL 32204-4712 | 2013-10-17 |
| Street Address |
232 PONTE VEDRA PARK DR |
| City | PONTE VEDRA BEACH |
| State | FL |
| Zip Code | 32082-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235168469 | Ponte Vedra Surgery Center | Clinic/Center | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-07-01 |
| 1427524008 | David J Bryant | Physician Assistant | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2018-10-22 |
| 1124418934 | Kenneth Panganiban | Physical Therapy Assistant | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2015-02-01 |
| 1073911350 | Linsey T Thompson | Physician Assistant | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2014-12-18 |
| 1154596898 | Stephan M. Esser | Family Medicine | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2008-04-24 |
| 1043400153 | James E Hardy IIi | Plastic Surgery | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2007-07-26 |
| 1639198708 | David T Harvey Md Pa | Dermatology | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-07-19 |
| 1295764165 | Kelly Deanne John | Physician Assistant | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518576818 | Specialty Eye Surgeons, Pa | Ophthalmology | 240 Ponte Vedra Boulevard, Suite 202, Ponte Vedra Beach, FL 32082 | 2020-07-23 |
| 1649820630 | Ponte Vedra Endodontics | Dentist | 822 A1a North, Ste 314, Ponte Vedra Beach, FL 32082 | 2019-09-12 |
| 1568988129 | Mustafa Bakir | General Practice | 1102 A1a, Ponte Vedra Beach, FL 32082 | 2017-08-16 |
| 1457890584 | Angelyn Sorgen | Nurse Practitioner | 1102 Hwy A1a, Suite 104, Ponte Vedra Beach, FL 32082 | 2017-02-22 |
| 1033575121 | Balanced Physician Care Pa | Family Medicine | 115 Professional Park Drive, Suite 104, Ponte Vedra Beach, FL 32082 | 2016-01-06 |
| 1528436060 | Robert Thompson II | Chiropractor | 135 Professional Drive, Suite 105, Ponte Vedra Beach, FL 32082 | 2015-09-14 |
| 1144628439 | Integrative Medical Group, Usa, LLC | Clinic/Center | 1102 A1a North, Suite 104, Ponte Vedra Beach, FL 32082 | 2014-12-18 |
| 1811308901 | Janice Wachtel, Phd, LLC | Psychologist | 100 Executive Way, Suite 110, Ponte Vedra Beach, FL 32082 | 2014-05-12 |
| 1578991154 | Nicole Theiler | Counselor | 171 Canal Blvd, Ponte Vedra Beach, FL 32082 | 2013-10-17 |
| 1982948006 | Daisamma Varghese | Nurse Practitioner | 860 A1an, Ponte Vedra, FL 32082 | 2012-11-15 |
| Find all providers in zip 32082 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750652814 | Arlette N. Shvartzman Md;pa | Specialist | 825 Ponte Vedra Blvd, Ponte Vedra Beach, FL 32082-3402 | 2012-01-21 |
| 1447419361 | Barbara Jane Silon | Specialist | 170 Landrum Ln, Ponte Vedra Beach, FL 32082-3823 | 2008-06-05 |
| 1174630644 | Robert W. Burk IIi | Specialist | 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-08-23 |
| 1093767147 | Sharyl J Truty | Specialist | 115 Professional Dr, Suite 104, Ponte Vedra Beach, FL 32082-6259 | 2006-05-17 |
| 1871558643 | Carl D Brueggemeyer | Specialist | 117 Osprey Cove Ln, Ponte Vedra Beach, FL 32082-6213 | 2006-04-17 |
| 1457755373 | First Coast Vein, LLC | Specialist | 330 A1a N, Suite 321, Ponte Vedra Beach, FL 32082-1823 | 2014-10-21 |
| 1205077120 | Emily Ann Polatas | Specialist | 13000 Sawgrass Village Cir, Suite 36, Ponte Vedra Beach, FL 32082-5016 | 2009-03-24 |
| 1841461100 | Ponte Vedra Plastic Surgery, Inc. | Specialist | 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2008-03-14 |
| 1962519454 | Claude Cayce Rumsey IIi | Specialist | 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-08-23 |
| 1053428466 | Brett J. Snyder | Specialist | 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | 2006-08-23 |
| Find all providers in PONTE VEDRA BEACH | ||||
| City | PONTE VEDRA BEACH |
| Zip Code | 32082 |
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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.