THEODORE R AMGOTT (NPI# 1861485518) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861485518 |
| Entity Type | Individual |
| Full Name | THEODORE R AMGOTT |
| Credential | MD |
| Practice Address |
1223 Gateway Dr Ste 2f Melbourne FL 32901-2607 |
| Mailing Address |
3300 S Fiske Blvd Rockledge FL 32955-4306 |
| Practice Telephone | 3217254500 |
| Practice Fax Number | 3217685082 |
| Mailing Telephone | 3217254500 |
| Mailing Fax Number | 3219517408 |
| Enumeration Date | 2005-08-29 |
| Last Update Date | 2018-04-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
ME44995 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 040914600 | 05 | |
| FL | MEDICARE | 05519W | 01 |
| Street Address |
1223 GATEWAY DR STE 2F |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-2607 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114469350 | Michelle Lynn Billings Williams | Nurse Practitioner | 1223 Gateway Dr Ste 2f, Melbourne, FL 32901-2607 | 2016-11-04 |
| 1306899026 | Enrique D Polanco | Internal Medicine | 1223 Gateway Dr Ste 2f, Melbourne, FL 32901-2607 | 2006-05-17 |
| 1386603934 | David L. Smull | Internal Medicine | 1223 Gateway Dr Ste 2f, Melbourne, FL 32901 | 2006-03-22 |
| 1679559199 | Mark J. Mendolla | Internal Medicine | 1223 Gateway Dr Ste 2f, Melbourne, FL 32901 | 2005-12-16 |
| 1528043163 | Prakash V Reddy | Internal Medicine | 1223 Gateway Dr Ste 2f, Melbourne, FL 32901-2607 | 2005-12-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790972271 | S. Jerry Pinto, Inc. | Internal Medicine | 1269 Foxridge Pl, Melbourne, FL 32940-6427 | 2007-09-28 |
| 1912928045 | Independent Lung Associates, Pa | Internal Medicine | 1314 Oak St, Melbourne, FL 32901-3111 | 2006-07-22 |
| 1235197781 | Simmy Jerry Pinto | Internal Medicine | 402 N Babcock St, Suite 402, Melbourne, FL 32935-7335 | 2006-05-03 |
| 1558346601 | Homer Phillips Stall | Internal Medicine | 200 E Sheridan Rd, Melbourne, FL 32901-3142 | 2005-12-13 |
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| 1245892611 | Blueapplecare, LLC. | Internal Medicine | 2625 Executive Park Dr Ste 101, Weston, FL 33331-3634 | 2019-07-05 |
| 1598321051 | South Broward Hospital District | Internal Medicine | 7369 Sheridan St Ste 302, Hollywood, FL 33024-2776 | 2019-05-10 |
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| 1538638853 | Arif Shakoor II LLC | Internal Medicine | 2257 Us Highway 441 N Ste C, Okeechobee, FL 34972-1943 | 2018-11-15 |
| 1396226304 | Adayiba Zamora | Internal Medicine | 10794 Pines Blvd Ste 205, Pembroke Pines, FL 33026-3920 | 2018-08-27 |
| 1366929465 | Ernesto E. Fonts, M.d, P.a. | Internal Medicine | 777 E 25th St Ste 512, Hialeah, FL 33013-3834 | 2018-07-23 |
| 1528552494 | Joseph C Daley IIi Md Fccp LLC | Internal Medicine | 1031 Se 9th Pl Unit 2, Cape Coral, FL 33990-3003 | 2018-06-14 |
| 1992200158 | James Lucio Md, Pa | Internal Medicine | 12627 Butler Bay Ct, Windermere, FL 34786-6102 | 2018-03-28 |
| Find all providers with the same taxonomy | ||||
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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.