DR. ALAN RYAN BLACKBURN II (NPI# 1588950547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588950547 |
| Entity Type | Individual |
| Full Name | DR. ALAN RYAN BLACKBURN II |
| Credential | M.D. |
| Practice Address |
1050 Se Monterey Rd Ste 400 Stuart FL 34994-4512 |
| Practice Telephone | 7722882400 |
| Practice Fax Number | 7724190144 |
| Mailing Telephone | 7722882400 |
| Mailing Fax Number | 7724190144 |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2018-11-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 4772 | GA | Allopathic & Osteopathic Physicians |
| Y | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
ME130977 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MEDICARE | JD517Z | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1120 15th St, Augusta, GA 309120004 | 7067211633 | 7067217501 |
| 124 Sw Chamber Ct, Port St Lucie, FL 349863496 | 7722882400 | 7724190144 |
| 9401 Sw Discovery Way, Port St Lucie, FL 349872376 | 7722882400 |
| Street Address |
1050 SE MONTEREY RD STE 400 |
| City | STUART |
| State | FL |
| Zip Code | 34994-4512 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194720797 | Caitlyn G Prucinsky | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2005-06-20 |
| 1942740360 | Susannah Johnson | Nurse Practitioner | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2017-03-04 |
| 1982065264 | Nicholas Demarco | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2016-03-14 |
| 1912363623 | Jayce Reed | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2016-01-11 |
| 1962836569 | Robert William Lambert | Physician Assistant | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2013-08-30 |
| 1568809937 | Chaquera Ernesta Jackson | Specialist/Technologist | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2013-05-26 |
| 1265744205 | Daniel A. Jones | Orthopaedic Surgery | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994 | 2010-07-07 |
| 1225221047 | Check C. Kam | Orthopaedic Surgery | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2007-08-24 |
| 1093837320 | Sharon Alicia Cain | Licensed Practical Nurse | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2007-04-06 |
| 1003999590 | Richard Anthony Planzo | Nurse Practitioner | 1050 Se Monterey Rd Ste 400, Stuart, FL 34994-4512 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912543711 | Prestige Medical Billing. Inc | Durable Medical Equipment & Medical Supplies | 2678 Se Willoughby Blvd, Stuart, FL 34994 | 2019-11-27 |
| 1780229203 | Katherine Ginn | Occupational Therapist | 809 Se Central Parkway, Stuart, FL 34994 | 2019-11-07 |
| 1972167294 | Melissa Callaham Lcsw | Social Worker | 900 East Ocean Blvd., Suite D-130, Office 26, Stuart, FL 34994 | 2019-04-23 |
| 1053881300 | Spencer Perna | Chiropractor | 632 Se Monterey Rd., Stuart, FL 34994 | 2018-11-29 |
| 1720563521 | National Vision Inc | Technician/Technologist | 2600 Southeast Federal Highway, Stuart, FL 34994 | 2018-09-27 |
| 1649767351 | Frank Alario Md & Associates | Non-Pharmacy Dispensing Site | 721 South Colorado Avenue, Stuart, FL 34994 | 2018-04-18 |
| 1609305499 | Wideline Thelemaque-claire | Behavior Technician | 900 E Ocean Blvd, Suite 130d, Stuart, FL 34994 | 2017-06-06 |
| 1316488984 | Jessica Gaffney | Social Worker | 416 Se Balboa Ave., Suite 200, Stuart, FL 34994 | 2017-03-16 |
| 1578012035 | Essentials Medical Group, LLC | Internal Medicine | 2694 Se Willoughby Blvd, Stuart, FL 34994 | 2016-09-26 |
| 1356898324 | Waters Edge Dermatology Global LLC | Surgery | 2601 S Kanner Highway, Stuart, FL 34994 | 2016-09-07 |
| Find all providers in zip 34994 | ||||
| Taxonomy Code | 2086S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgery of the Hand |
| A surgeon with expertise in the investigation, preservation and restoration by medical, surgical and rehabilitative means, of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679006373 | Hand Surgery of Central Florida | Surgery | 1241 S. Ridgewood Ave., Daytona Beach, FL 32114 | 2017-04-10 |
| 1841427861 | Jose L Borrero | Surgery | 630 Jasmine Rd, Altamonte Springs, FL 32701-4807 | 2009-06-17 |
| 1982895223 | George Dimitrios Papanicolaou | Surgery | 3272 W Lake Mary Blvd Ste 1810, Lake Mary, FL 32746-3589 | 2007-08-01 |
| 1629268842 | Jesse O Basadre Md Pa | Surgery | 1699 Sw 27th Ave, Miami, FL 33145 | 2007-07-25 |
| 1073712071 | Ehsan Esmaeili | Surgery | 1905 Clint Moore Rd., Suite 105, Boca Raton, FL 33496 | 2007-07-11 |
| 1770704520 | Medlink Management Services Inc | Surgery | 575 Se 3rd Ave, Lake Butler, FL 32054-2647 | 2007-05-01 |
| 1619196185 | Khader Muqtadir | Surgery | 13905 Bruce B Downs Blvd Ste B, Tampa, FL 33613-3998 | 2007-04-24 |
| 1609941244 | Jesse Orlando Basadre | Surgery | 1699 Sw 27 Avenue, Miami, FL 33145 | 2006-11-21 |
| 1275606634 | William W Adams | Surgery | 2299 9th Ave North, Suite 2c, Saint Petersburg, FL 33713 | 2006-11-15 |
| 1427089309 | Vikram P Mehta | Surgery | 4106 W. Lake Mary Blvd, Suite 224, Lake Mary, FL 32746 | 2006-07-06 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. ALAN RYAN BLACKBURN II.
| 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.