DR. PRODROMOS GORDON BORBOROGLU (NPI# 1770543894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770543894 |
| Entity Type | Individual |
| Full Name | DR. PRODROMOS GORDON BORBOROGLU |
| Credential | M.D. |
| Practice Address |
575 S Wickham Rd Suite A West Melbourne FL 32904-1170 |
| Mailing Address |
2200 W Eau Gallie Blvd Suite 200 Melbourne FL 32935-3165 |
| Practice Telephone | 3213085060 |
| Practice Fax Number | 3213085069 |
| Mailing Telephone | 3213085060 |
| Mailing Fax Number | 3213085069 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2015-05-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME99271 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE | P00631812 | 01 |
| FL | 280092600 | 05 |
| Street Address |
575 S WICKHAM RD SUITE A |
| City | WEST MELBOURNE |
| State | FL |
| Zip Code | 32904-1170 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538582366 | Medical Associates of Brevard LLC | Clinic/Center | 575 S Wickham Rd, Suite A, West Melbourne, FL 32904-1170 | 2014-01-30 |
| 1891098943 | Elizabeth Anne Sheppard | Physician Assistant | 575 S Wickham Rd, Suite A, West Melbourne, FL 32904-1170 | 2010-12-13 |
| 1245295997 | Anthony Saracino | Urology | 575 S Wickham Rd, Suite A, West Melbourne, FL 32904-1170 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710442264 | Urologic Specialists of Central Florida Pllc | Urology | 575 S Wickham Rd Ste A, West Melbourne, FL 32904-1170 | 2019-02-08 |
| 1578028197 | Prody Urology, Pllc | Urology | 575 S Wickham Rd Ste B, West Melbourne, FL 32904-1170 | 2019-02-07 |
| 1245295997 | Anthony Saracino | Urology | 575 S Wickham Rd, Suite A, West Melbourne, FL 32904-1170 | 2006-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770193450 | Urotelemedicine LLC | Urology | 8669 Nw 36th St Ste 325, Doral, FL 33166-6698 | 2020-08-06 |
| 1700411618 | Ackerman Cancer Center, Pa | Urology | 159 North 3rd St, Macclenny, FL 32063-2103 | 2020-03-11 |
| 1043844483 | Jesse Aaron Ory | Urology | 5555 Ponce De Leon Blvd Fl 4, Coral Gables, FL 33146-2513 | 2020-02-25 |
| 1215591565 | Advent Health | Urology | 420 Celebration Ave, Celebration, FL 34747-4683 | 2019-04-23 |
| 1366916843 | Dr. Carolyn Langford Urologic Solutions, LLC | Urology | 9400 Gladiolus Dr Ste 30, Fort Myers, FL 33908-9615 | 2019-01-17 |
| 1376016568 | Advanced Innovative Urology Pa | Urology | 4737 N Ocean Dr Ste 103, Lauderdale By The Sea, FL 33308-2920 | 2019-01-10 |
| 1306314281 | Urology Consultants of Boca Raton Pa | Urology | 825 Meadows Rd Ste 111, Boca Raton, FL 33486-2347 | 2018-11-08 |
| 1013490309 | Seetharam Bhat Kulthe Ramesh | Urology | 401 Celebration Pl Ste 200, Celebration, FL 34747-4971 | 2018-09-12 |
| 1386121770 | Florida Medical Specialists, LLC | Urology | 2302 60th Street Ct. W., Bradenton, FL 34209-0000 | 2018-07-27 |
| 1114427705 | Abraham L Woods IIi, M.d., Pa | Urology | 106 Boston Ave Ste 103, Altamonte Springs, FL 32701-4711 | 2018-02-20 |
| Find all providers with the same taxonomy | ||||
| City | WEST MELBOURNE |
| Zip Code | 32904 |
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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.