IDEAL IMAGE (NPI# 1679878904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679878904 |
| Entity Type | Organization |
| Organization Name | IDEAL IMAGE |
| Practice Address |
4866 Big Island Dr Ste #5 Jacksonville FL 32246-7498 |
| Practice Telephone | 9046520652 |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |
| Authorized Official Name | DR. RICHARD DEAN GLASSMAN (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9046520652 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9193543 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255789368 | Ideal Image | Specialist | 1485 Pine Ridge Road Unit #1, Naples, FL 34109 | 2016-05-31 |
| 1073978607 | Ideal Image | Nursing Care | 17504 Preserve Walk Ln, Tampa, FL 33647-3243 | 2015-12-26 |
| 1083008437 | Ideal Image | Clinic/Center | 1485 Pine Ridge Rd, Naples, FL 34109-2114 | 2015-03-24 |
| 1548551054 | Ideal Image | Clinic/Center | 3604 Springhurst Blvd, Louisville, KY 40241-4142 | 2011-05-02 |
| 1871985853 | Ideal Image | Clinic/Center | 330 San Lorenzo Ave, 2345, Coral Gables, FL 33146-1846 | 2015-02-27 |
| 1609272038 | Ideal Image | Clinic/Center | 330 San Lorenzo Ave, Coral Gables, FL 33146-1846 | 2014-11-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | Ideal Image Branding Elements Inc | 115 Haas Drive, Englewood, OH 45322 |
| New York State Corporations | IDEAL IMAGE CONSTRUCTION CORP | 167 Division Ave, Brooklyn, Ny 11211 |
| System for Award Management (SAM) Entities | IDEAL IMAGE DENTISTRY & SPA | 600 E Main St, Mandan, ND 58554-3536 |
| New York State Corporations | IDEAL IMAGE DEVELOPMENT CORPORATION | 15 North Mill Street, Nyack, New York 10960 |
| Connecticut Business Registrations | IDEAL IMAGE DEVELOPMENT CORPORATION | 4830 W. Kennedy Blvd., Ste. 440, Tampa, FL 33609 |
| Massachusetts Corporations | IDEAL IMAGE DEVELOPMENT, INC. | 4830 W. Kennedy Blvd., Ste 440, Tampa, FL 33609 |
| Colorado Business Entities | Ideal Image Group of Colorado, PLLC | 1 North Dale Mabry Hwy, Suite 1200, Yampa, FL 33609 |
| Connecticut Business Registrations | IDEAL IMAGE GROUP OF CONNECTICUT, LLC | 4830 West Kennedy Boulevard, Suite 440, Tampa, FL 33609 |
| Colorado Business Entities | Ideal Image Inc | 115 Haas Drive, Englewood, OH 45322 |
| Virginia Business Entities | IDEAL IMAGE INC. | 115 Haas Dr, Englewood, Ohio 45322-2845 |
| Street Address |
4866 BIG ISLAND DR STE #5 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32246-7498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301913 | Heather Gilmore | Nurse Practitioner | 4866 Big Island Dr, Jacksonville, FL 32246-7498 | 2019-11-20 |
| 1467980243 | Amanda Yadira Barrio | Nurse Practitioner | 4866 Big Island Dr, Jacksonville, FL 32246-7498 | 2017-05-24 |
| 1053711788 | Amy Elizabeth Maclean | Nurse Practitioner | 4866 Big Island Dr, Suite 5, Jacksonville, FL 32246-7498 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275179863 | Samar A Ibrahim | Pharmacist | 1305 N Orange Ave Green Cove Springs, Jacksonville, FL 32246 | 2019-11-19 |
| 1386290898 | Kelsey R Clevenger | Chiropractor | 4413 Town Center Parkway, Ste. 205, Jacksonville, FL 32246 | 2019-08-12 |
| 1700449006 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4712 Lake Center Drive, Space 107, Jacksonville, FL 32246 | 2019-04-22 |
| 1205399946 | Usa United Surgical Assistants | Clinic/Center | Bahri Surgical Center, 9726 Touchton Rd, Jacksonville, FL 32246 | 2019-04-10 |
| 1780173526 | Jules Novall LLC | Taxi | 4600 Touchton Rd, Jacksonville, FL 32246 | 2018-05-08 |
| 1740636307 | Jonathan David Browning | Psychiatry & Neurology | 4884 Deer Creek Drive W, Jacksonville, FL 32246 | 2016-05-12 |
| 1952770463 | Alignment Healthcare Florida LLC | Clinic/Center | 3520-1 St. Johns Bluff Rd., Jacksonville, FL 32246 | 2015-09-15 |
| 1558739417 | Jessica Brake | Physical Therapist | 9726 Touchton Road, Suite 104, Jacksonville, FL 32246 | 2015-09-09 |
| 1043686256 | Healthyeye Dba Vision Express LLC | Optometrist | 4871 Town Center Parkway #5, Jacksonville, FL 32246 | 2015-08-12 |
| 1477954675 | Joanivette Rodriguez | Psychologist | 3451 Saland Way Apt 504, Jacksonville, FL 32246 | 2014-09-08 |
| Find all providers in zip 32246 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881293868 | Maria Fe Guboc Rufano-sulit | Nurse Practitioner | 3682 Summerlin Ln, Jacksonville, FL 32224-1650 | 2020-10-21 |
| 1346849502 | Caitlin Flott | Nurse Practitioner | 14589 Camberwell Ln S, Jacksonville, FL 32258-1708 | 2020-10-20 |
| 1972101137 | Amanda Brooke Mills | Nurse Practitioner | 8459 Oak Crossing Dr W, Jacksonville, FL 32244-6949 | 2020-10-10 |
| 1649877200 | Shalom Barile | Nurse Practitioner | 1377 Ingleside Ave, Jacksonville, FL 32205-7733 | 2020-10-07 |
| 1013524248 | Claudia Joseph | Nurse Practitioner | 3331 Net Ct, Jacksonville, FL 32277-2735 | 2020-10-01 |
| 1063029577 | Erica Francisca Andrade | Nurse Practitioner | 5475 Turkey Creek Rd, Jacksonville, FL 32244-8549 | 2020-09-29 |
| 1568078418 | Jennifer Ruth Woodard | Nurse Practitioner | 29 Trinity Way, Jacksonville, AL 36265-5813 | 2020-09-16 |
| 1013522309 | William David Michal | Nurse Practitioner | 4417 Chippewa Dr, Jacksonville, FL 32210-6006 | 2020-09-13 |
| 1063025906 | Fabiola Baptiste | Nurse Practitioner | 9143 Philips Hwy Ste 110, Jacksonville, FL 32256-1365 | 2020-08-29 |
| 1295348464 | Debi Cohen | Nurse Practitioner | 11266 Cloverhill Ct, Jacksonville, FL 32257-1438 | 2020-08-27 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32246 |
Please comment or provide details below to improve the information on IDEAL IMAGE.
| 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.