RENATO M DURHAM MD PA (NPI# 1750692570) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750692570 |
| Entity Type | Organization |
| Organization Name | RENATO M DURHAM MD PA |
| Practice Address |
2080 W Eau Gallie Blvd Melbourne FL 32935-3185 |
| Practice Telephone | 3212546218 |
| Practice Fax Number | 3212546230 |
| Mailing Telephone | 3212546218 |
| Mailing Fax Number | 3212546230 |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |
| Authorized Official Name | RENATO M DURHAM (PRESIDENT) |
| Authorized Official Telephone | 3212546218 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
ME67647 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 758961100 | 05 |
| Street Address |
2080 W EAU GALLIE BLVD |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32935-3185 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144274358 | Space Coast Health Care Services | Internal Medicine | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-05-20 |
| 1508002544 | Derek Lee Eisnor Md Pa | Emergency Medicine | 2080 W Eau Gallie Blvd, Melbourne, FL 32935-3185 | 2008-12-22 |
| 1083864987 | Nicole F Taft | Physician Assistant | 2080 W Eau Gallie Blvd, Melbourne, FL 32935-3185 | 2008-09-26 |
| 1790946465 | Michael Alan Shapiro Md Pa | Emergency Medicine | 2080 W Eau Gallie Blvd, Melbourne, FL 32935-3185 | 2008-06-24 |
| 1144385139 | Atlantic Medical Associates LLC | Internal Medicine | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-12-27 |
| 1861568115 | Vicki L Cooper | Physician Assistant | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-11-28 |
| 1962578153 | Halcian L Graham | Physician Assistant | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-11-28 |
| 1447326640 | Jacques J Denizard | Physician Assistant | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-11-28 |
| 1699841932 | Tina M Campanile | Physician Assistant | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-11-28 |
| 1861568123 | Dale A Crites | Physician Assistant | 2080 W Eau Gallie Blvd, Suite A, Melbourne, FL 32935-3185 | 2006-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
| 1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
| 1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
| 1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
| 1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
| 1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
| 1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
| 1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
| 1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
| 1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
| Find all providers in zip 32935 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508002544 | Derek Lee Eisnor Md Pa | Emergency Medicine | 2080 W Eau Gallie Blvd, Melbourne, FL 32935-3185 | 2008-12-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982224259 | Excalibur Telemedical Services | Emergency Medicine | 405 Waterford Ln, Gulf Breeze, FL 32561-4872 | 2020-04-16 |
| 1225694953 | Good Care Rehab& Wellness Inc | Emergency Medicine | 885 N Powers Dr Ste B, Orlando, FL 32818-6842 | 2019-05-17 |
| 1568994556 | Hillard L Chemers | Emergency Medicine | 16145 Craigend Pl, Odessa, FL 33556-2818 | 2017-03-30 |
| 1790195469 | Albert Carl Maier | Emergency Medicine | 358 County Road 207a, East Palatka, FL 32131-4145 | 2014-05-05 |
| 1710319413 | Holy Cross Hospital, Inc | Emergency Medicine | 1115 S Federal Hwy, Ft Lauderdale, FL 33316-1256 | 2013-08-05 |
| 1790035921 | Elizabeth Hernandez | Emergency Medicine | 17121 Sw 281st St, Homestead, FL 33030-1905 | 2012-09-14 |
| 1821377201 | Urgent Care Physicians of Kendale Lakes LLC | Emergency Medicine | 14661 Sw 56 Street, Miami, FL 33175 | 2011-08-16 |
| 1316231608 | George T Besong Md Ob/gyn LLC | Emergency Medicine | 2728 Enterprise Rd, Suite 200, Orange City, FL 32763-8276 | 2011-06-03 |
| 1265662126 | Quick Care Med LLC | Emergency Medicine | 1907 Highway 44 W, Inverness, FL 34453-3801 | 2009-07-24 |
| 1578705273 | Laurie Ann Romig | Emergency Medicine | 8250 32nd Ave N, St Petersburg, FL 33710-2212 | 2009-03-27 |
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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.