ALEXANDER JAVIER BOLANOS (NPI# 1578900619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578900619 |
| Entity Type | Individual |
| Full Name | ALEXANDER JAVIER BOLANOS |
| Credential | M.D. |
| Practice Address |
1824 King St Ste 300 Jacksonville FL 32204-4736 |
| Mailing Address |
4205 Belfort Rd Ste 4015 Jacksonville FL 32216-3623 |
| Practice Telephone | 9043881820 |
| Practice Fax Number | 9043881827 |
| Mailing Telephone | 9044506017 |
| Mailing Fax Number | 9044506041 |
| Enumeration Date | 2013-05-30 |
| Last Update Date | 2020-07-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | TRN19046 | FL | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
ME143891 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1600 Sw Archer Rd, Room 4102, Gainesville, FL 326103003 | 3522650239 | 3522651107 |
| Street Address |
1824 KING ST STE 300 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992759740 | Kevin R. Long | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204 | 2006-05-19 |
| 1457975427 | Melody Karycki | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2020-06-04 |
| 1699271809 | Victoria Susan Cate | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2018-04-05 |
| 1821523713 | Latoya D Holton | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2017-04-27 |
| 1104365147 | Nadine Wlasiuk | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2017-02-22 |
| 1487013645 | Sunitha Menon | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2016-02-16 |
| 1154789386 | Christina Kuebler | Physician Assistant | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2016-02-02 |
| 1730554494 | Carrie Ann Santos | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2015-12-07 |
| 1992189245 | Leighanne Michelle Meade | Nurse Practitioner | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2015-07-16 |
| 1508271941 | Nima Taghipour | Internal Medicine | 1824 King St Ste 300, Jacksonville, FL 32204-4736 | 2014-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1619476785 | Synergy Health Group LLC | Internal Medicine | 7828 Collins Grove Rd, Jacksonville, FL 32256-7175 | 2018-02-05 |
| 1366950230 | Cardiac Cin of Jacksonville LLC | Internal Medicine | 1301 Riverplace Blvd # 800c, Jacksonville, FL 32207-9047 | 2018-01-13 |
| 1982677068 | Abdul Rahman Kani | Internal Medicine | 8245 Bayberry Rd, Jacksonville, FL 32256-7432 | 2006-02-09 |
| 1881197044 | John-paul Pham | Internal Medicine | 1907 Atlantic Blvd, Jacksonville, FL 32207-3405 | 2018-03-14 |
| 1891294856 | Synergy Health Group LLC | Internal Medicine | 7828 Collins Grove Rd, Jacksonville, FL 32256 | 2018-02-06 |
| 1013375195 | Duval Vascular Center, LLC | Internal Medicine | 915 W Monroe St, Suite 100, Jacksonville, FL 32204-1177 | 2016-02-04 |
| 1114332962 | Advanced Vascular Resources of Jacksonville, LLC | Internal Medicine | 4253 Salisbury Rd, Jacksonville, FL 32216-6121 | 2014-06-30 |
| 1992058333 | Omar Marwan Hamoui | Internal Medicine | 7011 A C Skinner Pkwy Ste 160, Jacksonville, FL 32256-6953 | 2012-10-23 |
| 1760751598 | Baptist Cardiology, Inc. | Internal Medicine | 3563 Phillips Hwy Ste 106a, Credentialing Department, Jacksonville, FL 32207-5663 | 2011-12-22 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.