DIMITRIOS PHILIPPES AGALIOTIS (NPI# 1790764272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790764272 |
| Entity Type | Individual |
| Full Name | DIMITRIOS PHILIPPES AGALIOTIS |
| Credential | MD |
| Practice Address |
1699 S 14th St Ste 2 Fernandina Beach FL 32034 |
| Mailing Address |
2234 Colonial Blvd Attn: Managed Care Dept. Fort Myers FL 33907-1412 |
| Practice Telephone | 9044271370 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-01-12 |
| Last Update Date | 2018-06-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
ME0065592 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000786497E | 05 | |
| FL | STAYWELL (MEDICAID) AND WELLCARE (MEDICARE) | 1245927 | 01 |
| FL | FLORIDA HEALTHCARE PLUS | P0022927 | 01 |
| FL | CAREPLUS | 1100413 | 01 |
| FL | BCBS | 43641 | 01 |
| GA | 000786497I | 05 | |
| FL | RR MEDICARE | P01593272 | 01 |
| FL | AVMED | 245885 | 01 |
| FL | 253978100 | 05 | |
| FL | SIMPLY HEALTHCARE | P10703334 | 01 |
| Street Address |
1699 S 14TH ST STE 2 |
| City | FERNANDINA BEACH |
| State | FL |
| Zip Code | 32034 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790772044 | Mathew Luke | Internal Medicine | 1699 S 14th St Ste 2, Fernandina Beach, FL 32034 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871059899 | Anna Fn Chu | Dietitian, Registered | Baptist Medical Center Nassau, 1250 South 18th Street, Fernandina Beach, FL 32034 | 2019-02-14 |
| 1841784550 | Kelly Ann Sayers | Social Worker | 1890 S 14th St Ste 110, Fernandina Beach, FL 32034 | 2018-06-15 |
| 1609302611 | Christian Giovanniello | Behavior Technician | 1743 Azalea Street, Fernandina Beach, FL 32034 | 2017-05-11 |
| 1770018467 | Beckerton Chiropractic Pllc | Chiropractor | 464073 East State Road 200, Yulee, FL 32034 | 2017-05-01 |
| 1114392438 | Jayde Marie Gray | Chiropractor | 5211 South Fletcher Ave., Suite 250, Amelia Island, FL 32034 | 2015-12-11 |
| 1760858369 | Sun Gallery Inc. | Eyewear Supplier (Equipment, not the service) | 1523 Sadler Road, Fernandina Beach, FL 32034 | 2015-08-18 |
| 1124419718 | Angela L Michels | Counselor | 1890 S. 14th St., #302, Fernandina Beach, FL 32034 | 2015-02-18 |
| 1336542075 | Sara Veronica Herreros | Physician Assistant | 1865 Lime Street, Suite 100, Fernandina Beach, FL 32034 | 2014-10-08 |
| 1366789471 | Elizabeth Ann Moore | Nurse Practitioner | 1348 S 18th St Ste 340, Fernandina Beach, FL 32034 | 2013-01-09 |
| 1043564289 | Summer Suzanne Delille | Dental Hygienist | 95054 Oriole St., Fernandina Beach, FL 32034 | 2012-11-08 |
| Find all providers in zip 32034 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790772044 | Mathew Luke | Internal Medicine | 1699 S 14th St Ste 2, Fernandina Beach, FL 32034 | 2005-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194343210 | Jayaben Patel | Internal Medicine | 11818 Shire Wycliffe Ct, Tampa, FL 33626-3329 | 2020-07-07 |
| 1922628833 | Heme Onc Call, LLC | Internal Medicine | 5825 Sw 117th St, Pinecrest, FL 33156-5007 | 2020-04-21 |
| 1457851552 | Yvette M Herrington | Internal Medicine | 425 S Parsons Ave Ste 101, Brandon, FL 33511-5290 | 2018-02-15 |
| 1104360221 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 658 Oviedo Medical Drive, Oviedo, FL 32765 | 2016-12-08 |
| 1225424369 | Florence Arnold | Internal Medicine | 3830 Bee Ridge Rd Ste 301, Sarasota, FL 34233 | 2015-04-15 |
| 1073901187 | Edward Mcaloon | Internal Medicine | 108 Homeport Dr, Palm Harbor, FL 34683-5409 | 2014-12-26 |
| 1063818235 | Barry M. Krein | Internal Medicine | 4220 Careywood Dr, Melbourne, FL 32934-7679 | 2014-11-14 |
| 1912311630 | David Longacre | Internal Medicine | 2439 Weymouth Dr, Clearwater, FL 33764-6556 | 2014-06-20 |
| 1508270778 | Gerard Chaaya | Internal Medicine | 4306 Alton Rd Fl 3, Miami Beach, FL 33140-2840 | 2014-06-16 |
| 1982026670 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 2100 W 1st St, Sanford, FL 32771-1603 | 2014-01-14 |
| Find all providers with the same taxonomy | ||||
| City | FERNANDINA BEACH |
| Zip Code | 32034 |
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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.