CHARLES L DOMSON II (NPI# 1841281557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841281557 |
| Entity Type | Individual |
| Full Name | CHARLES L DOMSON II |
| Credential | M.D. |
| Practice Address |
212 N 2nd St Leesburg FL 34748-5103 |
| Practice Telephone | 3524350723 |
| Practice Fax Number | 3524350724 |
| Mailing Telephone | 3524350723 |
| Mailing Fax Number | 3524350724 |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2015-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
ME73019 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 256714802 | 05 |
| Street Address |
212 N 2ND ST |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104219948 | Professional Radiology Associates | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2015-03-17 |
| 1962521294 | Professional Radiology Associates, P.a. | Specialist | 212 N 2nd St, Leesburg, FL 34748-5103 | 2007-03-28 |
| 1073504650 | Michael P O'neill | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2005-11-02 |
| 1285625046 | Jayson A Lord | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2005-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437610243 | Ashley Shamsa Martin | Behavior Technician | 292 Bent Oak Ct, Leesburg, FL 34748 | 2019-03-26 |
| 1891278875 | Luis O Aponte Mendoza | Physician Assistant | 704 Doctors Ct., Suite 101, Leesburg, FL 34748 | 2018-09-14 |
| 1881197903 | Physician Associates LLC | Internal Medicine | 22316 Us Highway 27, Leesburg, FL 34748 | 2018-03-15 |
| 1184136145 | Infinite Support Services LLC | In Home Supportive Care | 129 Grove Ridge Circle, 104, Leesburg, FL 34748 | 2017-10-31 |
| 1619403037 | Massage and Wellness Care | Health Maintenance Organization | 1218 W. Dixie Ave, Suite A, Leesburg, FL 34748 | 2017-05-04 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1023480332 | Juanita Elizabeth Simpson | Contractor | 1911 Harcourt Drive, Leesburg, FL 34748 | 2015-10-26 |
| 1467835900 | Serenity Choice Place, LLC | Community/Behavioral Health | 721 Balmoral Circle, Leesburg, FL 34748 | 2015-07-01 |
| 1356738397 | Touching Heart's Group Homes, LLC | Community/Behavioral Health | 31809 Sunpark Cir, Leesburg, FL 34748 | 2015-04-16 |
| 1386035269 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 1103 N 14th Street, Leesburg, FL 34748 | 2015-02-12 |
| Find all providers in zip 34748 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982162681 | Central Florida Imaging of Leesburg, LLC | Radiology | 106 W North Blvd Ste 104, Leesburg, FL 34748-5039 | 2019-03-12 |
| 1497202675 | Prime Radiology of Leesburg Inc | Radiology | 600 N W Blvd, Suite E, Leesburg, FL 34748 | 2016-09-06 |
| 1629002621 | David Michael Mellman | Radiology | 734 N. 3rd Street Suite 115, Leesburg, FL 34748 | 2006-07-10 |
| 1518940147 | David Lee Factor | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748-7601 | 2005-11-29 |
| 1427057603 | Keith E Rockey | Radiology | 4110 E Forest Glen Ave, Leesburg, IN 46538-9552 | 2005-07-19 |
| 1689236275 | Radiology Imaging Specialists LLC | Radiology | 616 N Palmetto St, Leesburg, FL 34748-4417 | 2019-07-03 |
| 1104219948 | Professional Radiology Associates | Radiology | 212 N 2nd St, Leesburg, FL 34748-5103 | 2015-03-17 |
| 1043500937 | Brittany Kristen Nagy | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748 | 2011-04-12 |
| 1962688366 | Christopher J Schaeffer | Radiology | 801 E Dixie Ave Ste 104, Leesburg, FL 34748 | 2008-01-15 |
| 1639380322 | Epic Teleradiology LLC | Radiology | 26540 Ace Ave, Suite A, Leesburg, FL 34748-8279 | 2007-05-24 |
| Find all providers in LEESBURG | ||||
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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.