ANGEL KIDS PEDIATRICS (NPI# 1619268612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619268612 |
| Entity Type | Organization |
| Organization Name | ANGEL KIDS PEDIATRICS |
| Practice Address |
13241 Bartram Park Blvd Suite 209 Jacksonville FL 32258-5212 |
| Practice Telephone | 9046742304 |
| Practice Fax Number | 9045511502 |
| Mailing Telephone | 9046742304 |
| Mailing Fax Number | 9045511502 |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2011-04-25 |
| Authorized Official Name | MRS. CAMILLE C GORDEN (NURSE PRACTITIONER) |
| Authorized Official Telephone | 9046742304 |
| Authorized Official Credential | ARNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SP0200X |
Clinical Nurse Specialist Specialization: Pediatrics |
ARNP9279833 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
13241 BARTRAM PARK BLVD SUITE 209 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32258-5212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306833587 | Mark Andrew Matey | Podiatrist | 13241 Bartram Park Blvd, Suite 1809, Jacksonville, FL 32258-5227 | 2005-10-03 |
| 1942808977 | Etleva Iliazi | Nurse Practitioner | 13241 Bartram Park Blvd, Jacksonville, FL 32258-5212 | 2020-10-12 |
| 1952830093 | Lauren Kessenich | Nurse Practitioner | 13241 Bartram Park Blvd, Jacksonville, FL 32258-5212 | 2017-06-11 |
| 1497295505 | Blayne O Yerby | Physician Assistant | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2017-03-08 |
| 1366981904 | Jennifer Mooney | Nurse Practitioner | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2017-02-15 |
| 1902344427 | Raquel S Watkins Md Pllc | Allergy & Immunology | 13241 Bartram Park Blvd, Suite 2601, Jacksonville, FL 32258-5212 | 2017-02-03 |
| 1457805756 | Pediatric Innovation Center, LLC | Pediatrics | 13241 Bartram Park Blvd, Suite 209, Jacksonville, FL 32258-5212 | 2016-08-04 |
| 1386097442 | Khoi M Le | Dentist | 13241 Bartram Park Blvd, Ste. 1705, Jacksonville, FL 32258-5212 | 2016-07-13 |
| 1629453246 | Julian Bungubung | Nurse Practitioner | 13241 Bartram Park Blvd, Suite 413, Jacksonville, FL 32258-5212 | 2015-07-24 |
| 1023496189 | Railing Chiropractic & Acupuncture | Chiropractor | 13241 Bartram Park Blvd, 509, Jacksonville, FL 32258-5212 | 2015-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437794237 | Nicoleta Descalzo | Behavior Technician | 12724 Grand Bay Parkway West, Suite 410, Jacksonville, FL 32258 | 2019-11-15 |
| 1992275572 | William Lundgren | Nurse Anesthetist, Certified Registered | 3625 University Blvd South, Jacksonville, FL 32258 | 2018-11-27 |
| 1104301159 | Emergency Physicians Inc | Emergency Medicine | 14534 Old St Augustine Rd, Suite 3110, Jacksonville, FL 32258 | 2018-09-26 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| 1679013932 | Optometry Vision Care Pllc | Optometrist | 14866 Old St. Augustine Rd Unit 110, Jacksonville, FL 32258 | 2017-03-06 |
| 1467991950 | North Florida Vision Group Inc | Optometrist | 14866 Old St. Augustine Rd., Suite 110, Jacksonville, FL 32258 | 2017-02-16 |
| 1124576566 | Revolution Chiropractic LLC | Chiropractor | 14866 Old St Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-14 |
| 1396291936 | Robyn Reaves | Nurse Practitioner | 12361 Richards Glen Ct, Jacksonville, FL 32258 | 2016-09-01 |
| 1326595927 | Lauren Cost | Chiropractor | 14866 Old St. Augustine Road, Suite 113, Jacksonville, FL 32258 | 2016-09-01 |
| 1487991170 | Mark Steven Colosimo | Pharmacist | 13820 Old St Augustine Road, Jacksonville, FL 32258 | 2013-01-15 |
| Find all providers in zip 32258 | ||||
| Taxonomy Code | 364SP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679821656 | Hope Jessecca Gunn | Clinical Nurse Specialist | Unf/s Hs 1 Unf Drive Building 39a, Jacksonville, FL 32224 | 2012-08-22 |
| 1407239759 | Kelsey Hughes-calhoun | Clinical Nurse Specialist | 8351 Westport Rd, Jacksonville, FL 32244-5901 | 2015-07-06 |
| 1518215805 | Erica Self | Clinical Nurse Specialist | 1539 Parental Home Rd, Jacksonville, FL 32216-3009 | 2012-08-17 |
| 1669667630 | Dawn E Turk | Clinical Nurse Specialist | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2007-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225663180 | Brandy Michelle Garcia | Clinical Nurse Specialist | 807 Wiltonway Dr, Plant City, FL 33563-7001 | 2020-03-11 |
| 1720639883 | Cynthia Lee Kling | Clinical Nurse Specialist | Arnold Palmer Hospital, 92 W. Miller St., Orlando, FL 32806 | 2019-09-20 |
| 1881182442 | Doris Ai Brown Shorkey | Clinical Nurse Specialist | 2201 N 50th Ave, Hollywood, FL 33021-4045 | 2018-04-28 |
| 1811351059 | Vladlena Eunus | Clinical Nurse Specialist | 4052 Sw 50th Rd, Ocala, FL 34474-9687 | 2016-04-13 |
| 1639637804 | Barbara A Lennon | Clinical Nurse Specialist | 13535 Nemours Pkwy, Orlando, FL 32827-7402 | 2019-03-06 |
| 1881067460 | Cheryl A Schmidt | Clinical Nurse Specialist | 6352 River Rd, New Port Richey, FL 34652-2241 | 2015-11-04 |
| 1669889176 | Amanda Szymanski | Clinical Nurse Specialist | 8200 S Jog Rd, Suite 203, Boynton Beach, FL 33472-2981 | 2014-07-16 |
| 1770835233 | Suellen M Black | Clinical Nurse Specialist | 4506 N Armenia Ave, Tampa, FL 33603-2732 | 2012-10-09 |
| 1053699231 | Nicole S Dinovitser | Clinical Nurse Specialist | 12955 Palms West Dr Ste 100, Loxahatchee, FL 33470-9212 | 2011-07-22 |
| 1215237466 | Karen Bounds | Clinical Nurse Specialist | 5190 Bayou Blvd Ste 7, Pensacola, FL 32503-2162 | 2010-10-21 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32258 |
Please comment or provide details below to improve the information on ANGEL KIDS PEDIATRICS.
| 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.