FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC (NPI# 1699137182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699137182 |
| Entity Type | Organization |
| Organization Name | FIRST COAST PEDIATRIC INFECTIOUS DISEASE LLC |
| Practice Address |
1555 Kingsley Ave Ste. 201 Orange Park FL 32073-4560 |
| Practice Telephone | 9043985614 |
| Practice Fax Number | 9043985617 |
| Mailing Telephone | 9043985614 |
| Mailing Fax Number | 9043985617 |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | SEBASTIAN R STANCIU (OWNER) |
| Authorized Official Telephone | 9043985614 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
ME89939 | FL | Allopathic & Osteopathic Physicians |
| Y | 2080P0208X |
Pediatrics Specialization: Pediatric Infectious Diseases |
ME89939 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1555 KINGSLEY AVE STE. 201 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720084577 | Jack E Cohen | Orthopaedic Surgery | 1555 Kingsley Ave, Ste 201, Orange Park, FL 32073-9202 | 2005-06-27 |
| 1649650771 | Melisia R Robinson | Nurse Practitioner | 1555 Kingsley Ave, 201-202, Orange Park, FL 32073-4560 | 2015-06-03 |
| 1023404290 | Renee Lehosit | Physical Therapist | 1555 Kingsley Ave, Orange Park, FL 32073-4560 | 2015-04-14 |
| 1306269741 | Joseph William Phillips | Nurse Practitioner | 1555 Kingsley Ave, Suite 201, Orange Park, FL 32073 | 2014-01-21 |
| 1861814063 | Prime Care Dental Center,pa | Clinic/Center | 1555 Kingsley Ave, Suite 306, Orange Park, FL 32073-4560 | 2014-01-08 |
| 1477803849 | Peter J. Pitocchi Md Pa | Internal Medicine | 1555 Kingsley Ave, Ste 501, Orange Park, FL 32073-4560 | 2012-09-13 |
| 1467702175 | Joan D Oleary Md Pl | Dermatology | 1555 Kingsley Ave, Suite 401, Orange Park, FL 32073-4560 | 2012-09-11 |
| 1447406467 | Jennifer Roy Ferrer | Counselor | 1555 Kingsley Ave, Suite 406, Orange Park, FL 32073-4560 | 2008-08-10 |
| 1851556211 | Emanuel Martinez Md and Associates | Psychiatry & Neurology | 1555 Kingsley Ave, Suite 101, Orange Park, FL 32073-4560 | 2008-07-25 |
| 1932363629 | Physicians Group Services Pa | Pediatrics | 1555 Kingsley Ave, Suite 601, Orange Park, FL 32073-4560 | 2008-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
| 1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
| 1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
| 1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
| 1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
| 1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
| 1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
| 1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
| 1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
| 1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
| Find all providers in zip 32073 | ||||
| Taxonomy Code | 2080P0208X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Infectious Diseases |
| A pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific knowledge to affect a better outcome for pediatric infections with complicated courses, underlying diseases that predispose to unusual or severe infections, unclear diagnoses, uncommon diseases and complex or investigational treatments. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417114968 | Alfredo Murciano Md Pa | Pediatrics | 330 Casuarina Concourse, Coral Gables, FL 33143-6508 | 2008-05-21 |
| 1851504864 | Michael Joseph Muszynski | Pediatrics | 415 Briercliff Dr, Orlando, FL 32806-2203 | 2007-05-07 |
| 1558580522 | Luis A Blanco | Pediatrics | 8752 Sw 8th St, Miami, FL 33174-3201 | 2007-04-25 |
| 1528281409 | Ivan Alberto Gonzalez | Pediatrics | 1580 N.w. 10th Avenue, Locator Code D4-4, Miami, FL 33136 | 2007-04-10 |
| 1710047121 | Alfredo Ivan Murciano | Pediatrics | 6537 Coral Way, Miami, FL 33155-1843 | 2006-12-08 |
| 1831261262 | Maria Del Pilar Gutierrez | Pediatrics | 1131 N 35th Ave Ste 310, Hollywood, FL 33021-5403 | 2006-11-14 |
| 1699706937 | Alejandro Isava | Pediatrics | 1520 Ne 26th Ave, Fort Lauderdale, FL 33304 | 2006-07-05 |
| 1952382251 | Sumita Bhaduri-mcintosh | Pediatrics | 1600 Sw Archer Rd Box 100296, Gainesville, FL 32610-1526 | 2005-11-14 |
| 1568458834 | Pablo M Laufer | Pediatrics | 3200 Sw 60th Ct, Suite 206, Miami, FL 33155-4000 | 2005-09-22 |
| 1922552876 | Pediatric Specialty Group, Inc. | Pediatrics | 3100 Sw 62nd Ave, Suite 206, Miami, FL 33155 | 2016-08-09 |
| Find all providers with the same taxonomy | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on FIRST COAST PEDIATRIC INFECTIOUS DISEASE 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.