DARK SIDE MEDICAL, LLC (NPI# 1609153030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609153030 |
| Entity Type | Organization |
| Organization Name | DARK SIDE MEDICAL, LLC |
| Practice Address |
5130 Cyrus Cir Birmingham AL 35242-4630 |
| Practice Telephone | 2059810414 |
| Practice Fax Number | 8883306501 |
| Mailing Telephone | 2059810414 |
| Mailing Fax Number | 8883806501 |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2011-11-14 |
| Authorized Official Name | DR. VICTOR ESTRADA MENDOZA (OWNER AND TREATING PHYSICIAN) |
| Authorized Official Telephone | 2569976182 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
25607 | AL | Ambulatory Health Care Facilities |
| Street Address |
5130 CYRUS CIR |
| City | BIRMINGHAM |
| State | AL |
| Zip Code | 35242-4630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003831454 | Victor E. Mendoza | Anesthesiology | 5130 Cyrus Cir, Birmingham, AL 35242-4630 | 2006-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558960138 | A Friend of Mind | Behavioral Analyst | 5271 Harvest Ridge Ln, Birmingham, AL 35242 | 2020-10-23 |
| 1295347789 | Restore Therapy Services, Ltd | Physical Therapist | 6328 Farley Lane, Birmingham, AL 35242 | 2020-08-18 |
| 1447894175 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 3201 Endeavor Lane, Vestavia Hills, AL 35242 | 2019-11-06 |
| 1952956468 | Publix Alabama, LLC | Durable Medical Equipment & Medical Supplies | 6219 Tattersall Blvd., Hoover, AL 35242 | 2019-08-02 |
| 1033670120 | Rachel Monahan -patterson | Registered Nurse | 7191 Cahaba Valley Road, Suite 300, Birmingham, AL 35242 | 2019-03-29 |
| 1891283818 | Elizabeth Mcrae | Counselor | 150 Glenwood Lane, Birmingham, AL 35242 | 2018-04-25 |
| 1326549429 | Mary Virginia Colvert | Nurse Practitioner | 200 Riverhill Business Park, #250, Birmingham, AL 35242 | 2018-02-23 |
| 1669980504 | Liberty Park Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 1940 Stonegate Dr Ste 30, Vestavia Hls, AL 35242 | 2018-01-12 |
| 1942710983 | Southern Dental Sleep Specialists LLC | Clinic/Center | 4960 Valleydale Rd Ste 100, Birmingham, AL 35242 | 2017-10-04 |
| 1922526557 | Sarah Katherine Fleming | Specialist/Technologist | 1524 Southern Drive, Birmingham, AL 35242 | 2017-09-04 |
| Find all providers in zip 35242 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437710183 | Cahaba Medical Care Foundation | Clinic/Center | 1305 Princeton Ave Sw, Birmingham, AL 35211-1544 | 2019-06-24 |
| 1750844775 | Wecare Tlc- Poa Birmingham | Clinic/Center | 2024 2nd Ave N Ste C-2, Birmingham, AL 35203-3732 | 2019-04-08 |
| 1124590468 | Ross Bridge Medical Center Pediatrics, LLC | Clinic/Center | 3635 Market St Ste B, Birmingham, AL 35226-6391 | 2018-12-27 |
| 1932465861 | Onmark Physical Therapy, LLC | Clinic/Center | 151 Narrows Pkwy Ste D, Birmingham, AL 35242-8638 | 2012-04-04 |
| 1083772560 | Med Help PC | Clinic/Center | One Lakeshore Drive, Ste 100, Birmingham, AL 35209-7271 | 2006-12-05 |
| 1972558831 | Brookwood Internal Medicine, P.C. | Clinic/Center | 2017 Canyon Road, Suite # 39, Birmingham, AL 35216-1928 | 2006-05-22 |
| 1104879741 | Norwood Clinic Inc | Clinic/Center | 2022 Brookwood Medical Center Drive, Suite 510, Birmingham, AL 35209-6898 | 2006-05-17 |
| 1295207520 | Ross Bridge Medical Practice LLC | Clinic/Center | 3635 Market St Ste A, Birmingham, AL 35226-6391 | 2018-12-27 |
| 1598154841 | University of Alabama Health Services Foundation | Clinic/Center | 500 22nd St S, Birmingham, AL 35233-3110 | 2015-01-09 |
| 1710299425 | University of Alabama At Birmingham | Clinic/Center | 930 20th St S, Suite 101, Birmingham, AL 35205-2610 | 2010-07-10 |
| Find all providers in BIRMINGHAM | ||||
| City | BIRMINGHAM |
| Zip Code | 35242 |
Please comment or provide details below to improve the information on DARK SIDE MEDICAL, LLC.
| 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.