JERRY WAYNE MAIDA (NPI# 1730279142) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730279142 |
| Entity Type | Individual |
| Full Name | JERRY WAYNE MAIDA |
| Credential | MD |
| Practice Address |
11945 San Jose Blvd #102 Jacksonville FL 32223 |
| Practice Telephone | 9042683937 |
| Practice Fax Number | 9042687725 |
| Mailing Telephone | 9042683937 |
| Mailing Fax Number | 9042687725 |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | ME0014582 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
11945 SAN JOSE BLVD #102 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299625 | Kenneth Michael Sekine | Obstetrics & Gynecology | 11945 San Jose Blvd, 400, Jacksonville, FL 32223-1613 | 2005-07-14 |
| 1801242128 | Brett Daniel O'connor | Optometrist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2016-05-05 |
| 1467797373 | North Florida Surgeons, Pa | Surgery | 11945 San Jose Blvd, #300, Jacksonville, FL 32223-1613 | 2012-12-04 |
| 1932455136 | Mark Edward Diebel | Surgery | 11945 San Jose Blvd, Jacksonville, FL 32223-1613 | 2012-07-25 |
| 1023370459 | Baptist Primary Care Inc | Internal Medicine | 11945 San Jose Blvd, Suite 301, Jacksonville, FL 32223-1613 | 2012-06-12 |
| 1417247669 | Florida Woman Care, LLC | Obstetrics & Gynecology | 11945 San Jose Blvd, Bldg 400, Jacksonville, FL 32223-1613 | 2011-04-08 |
| 1508186727 | Sirlys Arcon Rios | Internal Medicine | 11945 San Jose Blvd, Suite 301, Jacksonville, FL 32223-1613 | 2010-06-10 |
| 1396985396 | Colleen Sutton | Physical Therapist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2009-03-03 |
| 1578758132 | Brian Todd Young | Dentist | 11945 San Jose Blvd, Ste. 101, Jacksonville, FL 32223-1613 | 2007-09-07 |
| 1588854335 | Lindsey Beth Kern | Physical Therapist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2007-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790216729 | Kumar Sambhav | Ophthalmology | 580 W 8th Street, Tower - II, 3rd Floor, Department of Ophthalmology, Jacksonville, FL 32209 | 2017-03-22 |
| 1306227335 | Sepehr Bahadorani | Ophthalmology | 580 W 8th St Fl Towerii3, Uf College of Medicine - Jacksonville, Jacksonville, FL 32209-6533 | 2015-06-16 |
| 1467854240 | Mohammed Ali Tawfik Alyouzbaki | Ophthalmology | 6054 Wateredge Drive South, Jacksonville, FL 32211 | 2014-09-23 |
| 1841580214 | Chad Michael Kaplan | Ophthalmology | 653 West 8th St, Jacksonville, FL 32209 | 2011-04-19 |
| 1730479650 | Abdallah Mohamed Jeroudi | Ophthalmology | 2639 Oak St, Jacksonville, FL 32204 | 2011-04-12 |
| 1881915619 | Omar Gayasaddin | Ophthalmology | 7051 Southpoint Pkwy S Fl 3, Jacksonville, FL 32216-8713 | 2010-06-16 |
| 1952630121 | Ralph Alphonse Sawyer | Ophthalmology | 10061 Lakes End Ct, Jacksonville, FL 32256-4112 | 2009-12-16 |
| 1326193020 | Midwest Eye Associates, LLC | Ophthalmology | 1122 Veterans Dr, Suite B, Jacksonville, IL 62650-4032 | 2007-01-24 |
| 1023118379 | Jeffrey Herschel Levenson | Ophthalmology | 751 Oak St Ste 200, Jacksonville, FL 32204-3361 | 2006-09-25 |
| 1942317680 | Gerard A. Coluccelli | Ophthalmology | 931 Brookwood Rd, Jacksonville, FL 32207-4211 | 2006-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
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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.