DR. PAUL B KORNBERG (NPI# 1710943451) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710943451 |
| Entity Type | Individual |
| Full Name | DR. PAUL B KORNBERG |
| Credential | M.D. |
| Practice Address |
2914 N Boulevard Tampa FL 33602-1208 |
| Practice Telephone | 8132287696 |
| Practice Fax Number | 8132280677 |
| Mailing Telephone | 8132287696 |
| Mailing Fax Number | 8132280677 |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2011-10-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208100000X | Physical Medicine & Rehabilitation | ME0085060 | FL | Allopathic & Osteopathic Physicians |
| Y | 2081P0010X |
Physical Medicine & Rehabilitation Specialization: Pediatric Rehabilitation Medicine |
ME0085060 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 2641542-00 | 05 | |
| FL | CIGNA | 716175 | 01 |
| FL | BLUE CROSS | 13779 | 01 |
| FL | AETNA | 2850138 | 01 |
| FL | WELLCARE (NON-PAR) | N216229 | 01 |
| Street Address |
2914 N BOULEVARD |
| City | TAMPA |
| State | FL |
| Zip Code | 33602-1208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447234646 | Melinda H Hayes | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602-1208 | 2005-12-01 |
| 1619538279 | Petronella Cornelia Sekeres | Nurse Practitioner | 2914 N Boulevard, Tampa, FL 33602-1208 | 2019-06-25 |
| 1639628670 | Kristina Niccole Garavaglia | Nurse Practitioner | 2914 N Boulevard, Tampa, FL 33602-1208 | 2016-10-03 |
| 1700266608 | Stacy Ann Jordan | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602-1208 | 2015-06-05 |
| 1093135220 | Kadir Justin Carruthers | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602 | 2014-04-28 |
| 1528296266 | Fouzia Shabana Khan | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602-1208 | 2009-07-01 |
| 1538303912 | Rigoberto Nicholas Nunez | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602-1208 | 2009-04-29 |
| 1275714073 | Wheamei Jenq | Physician Assistant | 2914 N Boulevard, Tampa, FL 33602-1208 | 2007-11-20 |
| 1053538942 | Sheryce Marie Andrews | Physical Medicine & Rehabilitation | 2914 N Boulevard, Tampa, FL 33602-1208 | 2007-04-20 |
| 1356469795 | Thomas Scott | Physician Assistant | 2914 N Boulevard, Tampa, FL 33602-1208 | 2007-03-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306482088 | Michael P. Flynn | Radiology | 1003 Bay Harbour Place, Tampa, FL 33602 | 2019-11-18 |
| 1821649211 | Shannon Tracy Munz | Nurse Practitioner | 203 N Marion St, Tampa, FL 33602 | 2019-09-26 |
| 1932682846 | Ferrara Dental Pllc | Dentist | 201 East Kennedy Blvd, Suite 1425, Tampa, FL 33602 | 2018-09-07 |
| 1639668692 | Darrell Wayne Fennell Jr. | Counselor | 400 N Ashley Dr Ste 2600, Tampa, FL 33602 | 2018-05-05 |
| 1093233967 | Synergic Healthcare Solutions LLC | Clinic/Center | 303 W Palm Ave, Tampa, FL 33602 | 2017-08-31 |
| 1568980464 | Drsoncalls | General Practice | 449 S 12th St., Unit 2801, Tampa, FL 33602 | 2017-08-31 |
| 1386178283 | Charles Stuart | Occupational Therapy Assistant | 313 E. Oak Ave, Tampa, FL 33602 | 2017-04-18 |
| 1285172122 | Frank Watson | Chiropractor | 1004 North Florida Ave., Tampa, FL 33602 | 2017-02-10 |
| 1295189801 | Stephanie Buchman | Student in an Organized Health Care Education/Training Program | 1156 Shipwatch Circle, Tampa, FL 33602 | 2016-04-20 |
| 1093189896 | Jonnique Adjmul | Counselor | 300 E Madison St Ste 201, Tampa, FL 33602 | 2015-11-17 |
| Find all providers in zip 33602 | ||||
| Taxonomy Code | 2081P0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pediatric Rehabilitation Medicine |
| A physiatrist who utilizes an interdisciplinary approach and addresses the prevention, diagnosis, treatment and management of congenital and childhood-onset physical impairments including related or secondary medical, physical, functional, psychosocial and vocational limitations or conditions, with an understanding of the life course of disability. This physician is trained in the identification of functional capabilities and selection of the best of rehabilitation intervention strategies, with an understanding of the continuum of care. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate for PRM was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Early discussions underway |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033769310 | Kayla Marie Tornari | Physical Medicine & Rehabilitation | 6002 Nw 74th Ter, Parkland, FL 33067-1227 | 2019-09-18 |
| 1750840393 | Because You Can, LLC | Physical Medicine & Rehabilitation | 2901 1st Ave N Ste 101, St Petersburg, FL 33713-8640 | 2019-03-13 |
| 1780027870 | South Broward Hospital District | Physical Medicine & Rehabilitation | 4651 Sheridan Street, Suite 150, Hollywood, FL 33024 | 2013-04-09 |
| 1497884399 | First Step Therapeutics | Physical Medicine & Rehabilitation | 1104 Beville Road, Suite J, Daytona Beach, FL 32114-5765 | 2007-03-05 |
| 1982624771 | Pediatric Potentials, Inc. | Physical Medicine & Rehabilitation | 295 Waymont Ct, Lake Mary, FL 32746-6744 | 2006-07-21 |
| 1568073823 | Wesley Roland Innocent Jr. | Physical Medicine & Rehabilitation | 2685 Executive Park Dr, Weston, FL 33331-3651 | 2020-08-11 |
| 1851867204 | Hop, Skip and A Jump Pediatric Physical Therapy | Physical Medicine & Rehabilitation | 30201 Sw 172nd Ave, Homestead, FL 33030-4820 | 2018-10-23 |
| 1447761473 | Catherine Wright | Physical Medicine & Rehabilitation | 10250 Nw 53rd St, Sunrise, FL 33351-8023 | 2017-10-17 |
| 1841483393 | Margarita Correa LLC | Physical Medicine & Rehabilitation | 720 Almond St, Clermont, FL 34711-3124 | 2007-08-18 |
| 1356407068 | Ewa B Brandys | Physical Medicine & Rehabilitation | 13535 Nemours Pkwy, Orlando, FL 32827-7402 | 2006-12-28 |
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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.