WILTON MCLEAN REAVIS JR. (NPI# 1790753465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790753465 |
| Entity Type | Individual |
| Full Name | WILTON MCLEAN REAVIS JR. |
| Credential | M.D. |
| Practice Address |
1125 Us Highway 98 S Suite 101 Lakeland FL 33801-5852 |
| Practice Telephone | 8636837171 |
| Mailing Telephone | 8636837171 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2008-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
ME0031892 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 44252600 | 05 |
| Street Address |
1125 US HIGHWAY 98 S SUITE 101 |
| City | LAKELAND |
| State | FL |
| Zip Code | 33801-5852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720055791 | Ricardo E Duque | Pathology | 1125 Us Highway 98 S, Suite 101, Lakeland, FL 33801-5852 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508473802 | Camryn Nichole White | Assistant Behavior Analyst | 301 South Florida Ave, Lakeland, FL 33801 | 2020-09-30 |
| 1932719242 | Jimia Watkins | Home Health Aide | 2410 Lakeview St, Lakeland, FL 33801 | 2020-08-03 |
| 1396366886 | Erin Zimmer | Health Educator | 491 Lake Parker Ave, Lakeland, FL 33801 | 2020-05-06 |
| 1013473206 | Madelyn Claire Burley | Occupational Therapist | 1215 East Orange Street, Lakeland, FL 33801 | 2019-02-13 |
| 1992260319 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 1617 Us Highway 98 S, Lakeland, FL 33801 | 2019-02-11 |
| 1669908836 | Integrative Physical Medicine of Lakeland LLC | Specialist | 1205 East Magnolia St, Suite 105, Lakeland, FL 33801 | 2017-05-10 |
| 1689111502 | Daryl Dowding | Counselor | 390 Alcaia Rd., Lakeland, FL 33801 | 2017-01-30 |
| 1023481926 | Joseph D'alessandro | Specialist/Technologist | 111 Lake Hollingsworth Dr Box 4334, Lakeland, FL 33801 | 2015-11-02 |
| 1588030894 | Donna Lee Buckner | Specialist/Technologist | 111 Mosswood Road, Lakeland, FL 33801 | 2015-08-20 |
| 1144635780 | Donna Paige Mccraney | Nurse Practitioner | 111 Lake Hollingsworth Drive, Florida Southern College Student Health Center, Lakeland, FL 33801 | 2014-06-23 |
| Find all providers in zip 33801 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982024667 | Christopher A Rubadue | Pathology | 1125 Bartow Rd Ste 101, Lakeland, FL 33801-5845 | 2014-04-22 |
| 1225005226 | Craig Lariscy | Pathology | 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | 2006-03-08 |
| 1033308028 | Patricia M Mcnab | Pathology | 1125 Bartow Rd, Lakeland, FL 33801-5852 | 2007-10-16 |
| 1831131994 | Brian Joel Yoder | Pathology | 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | 2006-06-12 |
| 1649220872 | Lakeland Pathologists, Pa | Pathology | 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | 2006-05-10 |
| 1457329047 | Edward Garcia | Pathology | 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | 2006-03-09 |
| 1760459770 | Evander A Boynton IIi | Pathology | 1125 Bartow Rd, Suite 101, Lakeland, FL 33801-5852 | 2006-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780157321 | Richard Freij | Pathology | 9770 S Military Trl # B4-255, Boynton Beach, FL 33436-3207 | 2019-01-07 |
| 1447755137 | Brian Steven Mccarthy I | Pathology | 1719 Nw 23rd Ave Apt 1f, Gainesville, FL 32605-3005 | 2018-03-26 |
| 1841716123 | Kritika Krishnamurthy | Pathology | 4300 Alton Rd Ste 2400, Miami Beach, FL 33140-2948 | 2017-08-17 |
| 1982154167 | Johnny Paul Hughes | Pathology | 18317 Cypress Stand Cir, Tampa, FL 33647-1816 | 2016-10-11 |
| 1154870657 | Clinical Toxicology Pa | Pathology | 10269 Sw Village Pkwy, 102, Port Saint Lucie, FL 34987-2369 | 2016-09-25 |
| 1932584281 | Nichole Allen | Pathology | 2210 Marsh View Dr Unit 104, Wesley Chapel, FL 33544-4712 | 2015-07-29 |
| 1710368501 | Archi Patel | Pathology | 18311 Highwoods Preserve Pkwy Unit 6413, Tampa, FL 33647-1925 | 2015-06-17 |
| 1265839377 | Hugo Keiji Kaneku Nagahama | Pathology | 1600 Nw 10th Ave Rm 8149, Miami, FL 33136-1015 | 2014-12-04 |
| 1508278532 | Daniel Sanchez | Pathology | 7000 Sw 62nd Ave Ste 601, South Miami, FL 33143 | 2014-05-26 |
| 1508277799 | Kyle White | Pathology | 7188 Estero Dr, Lake Worth, FL 33463-5600 | 2014-05-11 |
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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.