LIFETIME MEDICAL CARE PA (NPI# 1790793016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790793016 |
Entity Type | Organization |
Organization Name | LIFETIME MEDICAL CARE PA |
Practice Address |
2300 Park Ave Suite 203 Orange Park FL 32073-5571 |
Mailing Address |
5000 Us Highway 17 Suite 18-302 Orange Park FL 32003-8231 |
Practice Telephone | 9042780016 |
Practice Fax Number | 9042784217 |
Mailing Telephone | 9042780016 |
Mailing Fax Number | 9042784217 |
Enumeration Date | 2006-08-03 |
Last Update Date | 2008-11-06 |
Authorized Official Name | NIDAL EL RIMAWI (PRESIDENT) |
Authorized Official Telephone | 9042780016 |
Authorized Official Credential | M.D. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
ME81222 | FL | Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | BLUE CROSS BLUE SHIELD | 01528 | 01 |
FL | CIGNA | 6965204 | 01 |
FL | AETNA | 7388361 | 01 |
Street Address |
2300 PARK AVE SUITE 203 |
City | ORANGE PARK |
State | FL |
Zip Code | 32073-5571 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194728303 | Paul A Bednarzyk | Internal Medicine | 2300 Park Ave, Suite 101-b, Orange Park, FL 32073-5572 | 2005-05-23 |
1538526157 | Tiffany Reshae Florence | Nurse Practitioner | 2300 Park Ave, Orange Park, FL 32073-5571 | 2016-01-27 |
1902261316 | Se Orthopedic Specialists | Non-Pharmacy Dispensing Site | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2015-12-30 |
1568852739 | Jason M Fetty | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2015-01-27 |
1730500489 | Southeast Orthopedic Specialists, Inc. | Specialist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-12-26 |
1023445004 | Nedzad Cavka | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-10-04 |
1104163138 | Krystal Jane Newbern | Physical Therapist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-01-10 |
1235489287 | Mark A Arrigenna | Physician Assistant | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2012-09-18 |
1841578556 | The Smart Group, LLC | Pharmacy | 2300 Park Ave, Suite 100, Orange Park, FL 32073-5571 | 2011-07-29 |
1912136292 | Housecall Home Health, L.L.C. | Home Health | 2300 Park Ave, Suite 102, Orange Park, FL 32073-5571 | 2009-07-08 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891309423 | Kingsley Endoscopy Center LLC | Clinic/Center | 970 Kingsley Avenue, Orange Park, FL 32073 | 2020-09-01 |
1962028688 | Esra Sari | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue., Orange Park Medical Center, Orange Park, FL 32073 | 2020-06-18 |
1104441146 | Zeshan Tariq Malik | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue, Office of Graduate Medical Educa, Orange Park, FL 32073 | 2020-06-16 |
1902421894 | Ameer Hamza | Student in an Organized Health Care Education/Training Program | 2001, Kingsley Avenue Office of Graduate Medical Educat, Orange Park, FL 32073 | 2020-06-16 |
1497378103 | Fawad Ahmed Rashid | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Avenue Office of Graduate Medical Educati, Orange Park, FL 32073 | 2020-05-28 |
1477174985 | Hannan Asghar | Student in an Organized Health Care Education/Training Program | Office of Graduate Medical Education 2001 Kingsley, Orange Park, FL 32073 | 2020-05-06 |
1902427156 | Emmanuel Iyanuloluwa Morakinyo | Student in an Organized Health Care Education/Training Program | 413 Deer View Avenue, 2001 Kingsley Ave, Orange Park, FL 32073 | 2020-04-29 |
1437799327 | Dalande Leger | Behavior Technician | 1563 Kingsley Ave Suite 103, Orange Park, FL 32073 | 2020-01-08 |
1215598313 | Mohammad Harisullah Khan | Student in an Organized Health Care Education/Training Program | 2001 Kingsley Ave, Gme Office, Orange Park, FL 32073 | 2019-06-28 |
1558927970 | Preetha Kamath | Student in an Organized Health Care Education/Training Program | Orange Park Medical Center, 2001 Kingsley Ave, Orange Park, FL 32073 | 2019-05-10 |
Find all providers in zip 32073 |
Taxonomy Code | 261QP2300X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Primary Care |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205441615 | Washington Hills Primary Care | Clinic/Center | 4645 Plantation Oaks Blvd, Orange Park, FL 32065-3652 | 2020-09-11 |
1124050711 | Meadowlands Medical Center,pa | Clinic/Center | 179 College Dr, Ste 17, Orange Park, FL 32065-7705 | 2006-07-06 |
1942481429 | Family First Primary Care Pa | Clinic/Center | 1075 Oakleaf Plantation Pkwy, Suite 108, Orange Park, FL 32065-3624 | 2007-11-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174122337 | Life Line Medical Group Inc | Clinic/Center | 12595 Sw 137th Ave Ste 206, Miami, FL 33186-4221 | 2020-10-20 |
1558977926 | Ohi West Medical Group, LLC | Clinic/Center | 603 7th St S Ste 350, St Petersburg, FL 33701-4732 | 2020-09-21 |
1699380329 | Premier Health System LLC | Clinic/Center | 12970 Sw 133rd Ct Ste A, Miami, FL 33186-5806 | 2020-09-10 |
1093328163 | Sunmed Group LLC | Clinic/Center | 2499 Glades Rd Ste 305a, Boca Raton, FL 33431-7202 | 2020-08-28 |
1790398246 | Emc 360, LLC | Clinic/Center | 1008 Juliette Blvd, Mount Dora, FL 32757-6500 | 2020-08-25 |
1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
1912517152 | Curos Inc | Clinic/Center | 1425 Sw 8th Ct, Ft Lauderdale, FL 33312-7291 | 2020-08-03 |
1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
1023628351 | Ase Telehealth Inc | Clinic/Center | 5851 Timuquana Rd Ste 104, Jacksonville, FL 32210-7890 | 2020-08-02 |
Find all providers with the same taxonomy |
City | ORANGE PARK |
Zip Code | 32073 |
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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.