JACKSONVILLE NEUROLOGICAL CLINIC, P.A. (NPI# 1710934930) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710934930 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE NEUROLOGICAL CLINIC, P.A. |
| Practice Address |
1895 Kingsley Ave Ste 805 Orange Park FL 32073-4410 |
| Mailing Address |
Po Box 17809 Jacksonville FL 32245-7809 |
| Practice Telephone | 9042762220 |
| Practice Fax Number | 9042762578 |
| Mailing Telephone | 9047230015 |
| Mailing Fax Number | 9043380951 |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2007-11-20 |
| Authorized Official Name | DENNIS DEWEY (PRESIDENT) |
| Authorized Official Telephone | 9042762220 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RAILROAD MEDICARE | CF1455 | 01 |
| FL | BCBS | 00506 | 01 |
| Street Address |
1895 KINGSLEY AVE STE 805 |
| City | ORANGE PARK |
| State | FL |
| Zip Code | 32073-4410 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073840435 | Dennis D. Dewey, M.d., P.a. | Psychiatry & Neurology | 1895 Kingsley Ave Ste 805, Orange Park, FL 32073-4410 | 2009-11-05 |
| 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 | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134443583 | Medical Neurodiagnostics & Neurology Pl | Specialist | 1536 Kingsley Ave Ste 116, Orange Park, FL 32073-4525 | 2010-03-15 |
| 1841469459 | Carrie A Kissinger | Specialist | 2256 Hopkins St, Orange Park, FL 32073-5222 | 2008-02-27 |
| 1588619068 | Olabisi T Rashied-walker | Specialist | 401 Cottage Cove Ct, Orange Park, FL 32073 | 2006-05-23 |
| 1598734154 | Mihaela Ionescu | Specialist | 1536 Kingsley Ave Ste 118, Orange Park, FL 32073-4525 | 2006-03-16 |
| 1053388306 | Anjan R Parghi | Specialist | 847 Park Ave, Orange Park, FL 32073 | 2006-03-07 |
| 1659357705 | Laurie Valloneshimko | Specialist | 1626 Sheffield Pl, Orange Park, FL 32073-5268 | 2005-12-21 |
| 1114900115 | James Sloan | Specialist | 653 Kingsley Ave, Orange Park, FL 32073-5467 | 2005-11-22 |
| 1346240504 | Rajesh Kumar Vishen | Specialist | 165 Wells Rd, Orange Park, FL 32073-3035 | 2005-07-28 |
| 1184627374 | Melissa C Kirby | Specialist | 1600 Park Ave, Ste 7, Orange Park, FL 32073-4999 | 2005-05-23 |
| 1629473822 | Vk Medical Group LLC | Specialist | 1218 Park Ave, Orange Park, FL 32073-4152 | 2014-10-30 |
| Find all providers in ORANGE PARK | ||||
| City | ORANGE PARK |
| Zip Code | 32073 |
Please comment or provide details below to improve the information on JACKSONVILLE NEUROLOGICAL CLINIC, P.A..
| 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.