NEUREPAIR BRAIN AND SPINE WELLNESS CENTERS (NPI# 1679185003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679185003 |
Entity Type | Organization |
Organization Name | NEUREPAIR BRAIN AND SPINE WELLNESS CENTERS |
Practice Address |
14000 Fivay Rd Hudson FL 34667-7103 |
Mailing Address |
10701 Laurel Vista Way Tampa FL 33647-3730 |
Practice Telephone | 4125250031 |
Mailing Telephone | 4125250031 |
Enumeration Date | 2020-08-18 |
Last Update Date | 2020-08-18 |
Authorized Official Name | DR. DERRICK A DUPRE (PRESIDENT) |
Authorized Official Telephone | 4125250031 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities |
Street Address |
14000 FIVAY RD |
City | HUDSON |
State | FL |
Zip Code | 34667-7103 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376512319 | Candace Koney-laryea | Anesthesiology | 14000 Fivay Rd, Hudson, FL 34667 | 2006-03-14 |
1265039820 | Carthia Joachim | Nurse Practitioner | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-10-07 |
1245844604 | Margaret Rose Little | Anesthesiologist Assistant | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-09-03 |
1689283004 | Joseph Gerald Glanton | Anesthesiologist Assistant | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-07-31 |
1528680956 | Jessica Jocelyn Chan | Pharmacist | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-05-07 |
1972122877 | Aaron Pingel | Anesthesiologist Assistant | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-04-10 |
1407485071 | Stamati Damalos | Student in an Organized Health Care Education/Training Program | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-04-06 |
1265061717 | David Abergel | Student in an Organized Health Care Education/Training Program | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-04-06 |
1780213207 | Aaron Benjamin Turk | Student in an Organized Health Care Education/Training Program | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-04-06 |
1891324497 | Ian Paul Ciesielski | Student in an Organized Health Care Education/Training Program | 14000 Fivay Rd, Hudson, FL 34667-7103 | 2020-04-06 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417571431 | Andrea E Steyer | Speech-Language Pathologist | 7927 Sr-52 W, Hudson, FL 34667 | 2020-06-05 |
1760956288 | Helen Edith Yaworski | Emergency Medicine | Bayonet Point Emergency Department, 14000 Fivay Rd, Hudson, FL 34667 | 2019-01-17 |
1104308329 | Mark Felix Roldan | Nurse Practitioner | 13944 Lakeshore Blvd Ste C, Hudson, FL 34667 | 2018-09-04 |
1285181867 | Dawnlee Basile-wood | Counselor | 9416 Dibot Court, Hudson, FL 34667 | 2016-09-01 |
1679951321 | Joseph Robbins | Internal Medicine | 14000 Fivay Road, Hudson, FL 34667 | 2015-05-14 |
1043602733 | Martiale Faustin | Registered Nurse | 12715 Clock Tower Pkwy, Hudson, FL 34667 | 2015-03-04 |
1720418015 | Olive Spoeth | Assisted Living Facility | 8711 Cutlass Dr., Hudson, FL 34667 | 2013-11-22 |
1891093365 | Saxon Rehab Management LLC. | Occupational Therapist | 12404 Cobblestone Dr, Hudson, FL 34667 | 2011-03-08 |
1174768055 | Anthony Charles Stover | Behavioral Analyst | 14610 Conner Drive, Hudson, FL 34667 | 2008-12-08 |
1356594451 | Jill Bona Garcia | Speech-Language Pathologist | 11820 Denton Ave, Hudson, FL 34667 | 2008-11-03 |
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Taxonomy Code | 261QH0100X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Health Service |
Definition to come... |
Notes: [7/1/2006: modified title] |
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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.