MAURA ANDRONIC (NPI# 1588704407) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588704407 |
| Entity Type | Individual |
| Full Name | MAURA ANDRONIC |
| Credential | MD |
| Practice Address |
1000 Mar Walt Dr Fort Walton Beach FL 32547-6708 |
| Practice Telephone | 8507299343 |
| Practice Fax Number | 8553733605 |
| Mailing Telephone | 8507299343 |
| Mailing Fax Number | 8553733605 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2019-10-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
ME142925 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
35078267 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | ANTHEM BCBS | 000000217363 | 01 |
| WV | WV WORKERS COMP. | 1055236 | 01 |
| NY | VALUE OPTIONS | 163348 | 01 |
| WV | MOUNTAIN STATE BCBS | 000062778 | 01 |
| OH | MAGELLAN BEHAVIORAL HEALT | 267472000 | 01 |
| OH | 2188707 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 66680 Clark Rd, Saint Clairsville, OH 439509212 | 7403106123 | 7405260122 |
| Street Address |
1000 MAR WALT DR |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6708 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699779389 | Hien Dao | Emergency Medicine | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2005-06-09 |
| 1619578663 | Noles Medical Services Inc | Clinic/Center | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2020-11-05 |
| 1629686878 | Eric Daniel Hinojosa | Nurse Practitioner | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2020-07-14 |
| 1548889215 | Jennifer D Grady | Nurse Practitioner | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2020-04-13 |
| 1578194247 | Laura Pavel Ketelsen | Nurse Anesthetist, Certified Registered | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2020-01-30 |
| 1508422106 | Jamie Marie Herndon | Registered Nurse | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2019-05-20 |
| 1801354477 | Victoria Ann Miles-nance | Nurse Anesthetist, Certified Registered | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2019-03-03 |
| 1447723457 | Jolyn Marie Pelesky | Nurse Anesthetist, Certified Registered | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2019-01-03 |
| 1346718442 | Hannah Beth Webster | Nurse Practitioner | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2018-11-06 |
| 1104301332 | Nicholas Joseph Dokianos | Internal Medicine | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2018-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568546505 | Ofelia K Borlongan | Psychiatry & Neurology | 153 Eldredge Rd, Fort Walton Beach, FL 32547-1346 | 2006-10-25 |
| 1609988112 | Victor De Moya | Psychiatry & Neurology | 403a Hollywood Blvd,, Nw, Suite 104, Fort Walton Beach, FL 32548-4531 | 2006-08-31 |
| 1710097704 | Emerald Coast Mood & Memory Pa | Psychiatry & Neurology | 922 Mar Walt Dr, Suite 100, Fort Walton Beach, FL 32547-6630 | 2006-08-30 |
| 1740397025 | Jerzy Grzebieluch | Psychiatry & Neurology | 4 2nd St Se, Fort Walton Beach, FL 32548-5502 | 2006-08-24 |
| 1578513230 | Hyundong Steven Hahn | Psychiatry & Neurology | 928d Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2006-05-11 |
| 1922086867 | Patricia Harrison | Psychiatry & Neurology | 1025 Beal Pkwy Nw, Suite B-1, Fort Walton Beach, FL 32547-1481 | 2005-12-31 |
| 1407191158 | Maria Elen P Gajo Md Pa | Psychiatry & Neurology | 68 Beal Pkwy Sw, Fort Walton Beach, FL 32548-5331 | 2012-12-06 |
| 1669637724 | Brittany Williams | Psychiatry & Neurology | 1000 Mar Walt Dr, Fort Walton Beach, FL 32547-6708 | 2008-07-28 |
| 1275739021 | Michael Fahey Traver | Psychiatry & Neurology | 1000 Mar Walt Drive, Ptu, Fort Walton Beach, FL 32547 | 2007-06-26 |
| 1396834024 | Starfish Psychiatric Services Pl | Psychiatry & Neurology | 68 Beal Pkwy Sw, Fort Walton Beach, FL 32548-5331 | 2006-10-12 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
Please comment or provide details below to improve the information on MAURA ANDRONIC.
| 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.