DR. MITCHELL DUTERTE (NPI# 1558345462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558345462 |
| Entity Type | Individual |
| Full Name | DR. MITCHELL DUTERTE |
| Credential | MD |
| Practice Address |
4355 Nw American Ln Lake City FL 32055-4828 |
| Practice Telephone | 3867586094 |
| Practice Fax Number | 3867586995 |
| Mailing Telephone | 3867586094 |
| Mailing Fax Number | 3867586995 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
87014 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2688666000 | 05 |
| Street Address |
4355 NW AMERICAN LN |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32055-4828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922082833 | Rizwana Thanawala | Internal Medicine | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2005-12-05 |
| 1497207559 | Pathology Associates of North Florida | Clinical Medical Laboratory | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2016-10-25 |
| 1710266895 | Lake City Institute of Neurology Pa | Psychiatry & Neurology | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2011-08-08 |
| 1386835601 | Naga Lakshmana Prasad Nidadavolu | Psychiatry & Neurology | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2007-08-05 |
| 1124167457 | Shawn Waugh | Physician Assistant | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2007-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114439510 | Melissa Fay Peters | Nurse Practitioner | 5085 West Us Highway 90, Lake City, FL 32055 | 2017-10-26 |
| 1851801765 | Stephanie Jo Nogle | Occupational Therapist | Brooks Americare: 4251 Nw American Ln, #103, Lake City, FL 32055 | 2017-10-05 |
| 1831617273 | Erica Mayo | Pharmacist | 4846 Nw Lake Jeffery Rd., Lake City, FL 32055 | 2017-09-06 |
| 1144759333 | Jerry Hamilton Cheesman | Dentist | 217 Ne Franklin Sreet, Lake City, FL 32055 | 2017-06-09 |
| 1487183745 | Joshua Allore | Dentist | 2970 W Us Highway 90., Lake City, FL 32055 | 2017-06-08 |
| 1497298418 | Careing Hands | Preferred Provider Organization | 1471nw Queen Rd, Lakecity, FL 32055 | 2016-11-22 |
| 1881148278 | Corniqueca Stewart-simmons | Nurse Practitioner | 340 Nw Commerce Drive, Lake City, FL 32055 | 2016-08-15 |
| 1164809141 | Latasha Harten-jones | Licensed Practical Nurse | 443 Ne Sims Dr, Lake City, FL 32055 | 2015-04-29 |
| 1154716447 | Lindsey Morton | Counselor | 219 Se Baya Avenue, Lake City, FL 32055 | 2015-04-02 |
| 1124439351 | Tynette Jordan | Counselor | 708 N.w Wilson St., Lake City, FL 32055 | 2014-05-09 |
| Find all providers in zip 32055 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801866405 | Mohammad A Faisal | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| 1922082833 | Rizwana Thanawala | Internal Medicine | 4355 Nw American Ln, Lake City, FL 32055-4828 | 2005-12-05 |
| 1194945097 | Rizwana Thanawala Md Pa | Internal Medicine | 4367 Nw American Ln, Lake City, FL 32055-4828 | 2007-04-26 |
| 1629048228 | Ricardo J Rosado | Internal Medicine | 1283 Sw State Road 47, Suite 104, Lake City, FL 32025-0489 | 2006-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093321382 | Charlotte Harbor Gastroenterology LLC | Internal Medicine | 2811 Tamiami Trl Ste I, Port Charlotte, FL 33952-5135 | 2020-09-22 |
| 1750907614 | Michael G. Valladares D.o. P.a. | Internal Medicine | 10302 Sw 116th St, Miami, FL 33176-4049 | 2020-06-17 |
| 1578100996 | Alex Aziz Al Khoury | Internal Medicine | 1120 Nw 14th St. Suite 1112, Miami, FL 33136 | 2019-12-04 |
| 1750922399 | Gastroenterology Care Specialists, LLC | Internal Medicine | 550 Redstone Ave W Ste 430, Crestview, FL 32536-6457 | 2019-10-04 |
| 1194375378 | Digestive and Liver Disease Institute of Florida, LLC | Internal Medicine | 505 W Oak St Ste 202, Kissimmee, FL 34741-4986 | 2019-09-18 |
| 1659833002 | Steven L Diamond | Internal Medicine | 5606 Vintage Oaks Terrace, Delray Beach, FL 33484 | 2019-04-04 |
| 1225507601 | Linmec Corp | Internal Medicine | 4531 Deleon St Ste 215, Fort Myers, FL 33907-1279 | 2018-11-15 |
| 1912474156 | Eileen E Kim | Internal Medicine | 5117 Fiorella Ln, Sanford, FL 32771-5449 | 2018-10-25 |
| 1790251197 | Gabriel Benitez | Internal Medicine | 2330 Wilton Dr, Wilton Manors, FL 33305-1249 | 2018-10-23 |
| 1043786833 | Union Medical Group | Internal Medicine | 6300 Corporate Ct Ste 105, Fort Myers, FL 33919-3513 | 2018-10-18 |
| Find all providers with the same taxonomy | ||||
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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.