KETTIA NOEL (NPI# 1891395430) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891395430 |
| Entity Type | Individual |
| Full Name | KETTIA NOEL |
| Practice Address |
1573 Se Clearbrook St Port Saint Lucie FL 34983-4050 |
| Practice Telephone | 5615033273 |
| Mailing Telephone | 5615033273 |
| Enumeration Date | 2020-10-30 |
| Last Update Date | 2020-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
L20000294693 | FL | Ambulatory Health Care Facilities |
| Street Address |
1573 SE CLEARBROOK ST |
| City | PORT SAINT LUCIE |
| State | FL |
| Zip Code | 34983-4050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588224109 | Skytop Transportation Inc | Non-emergency Medical Transport (VAN) | 6947 Nw Daffodil Ln, Port Saint Lucie, FL 34983 | 2019-06-17 |
| 1063985125 | Ralph Glen Manning | Counselor | 289 Se Sagamore Terrace, Port Saint Lucie, FL 34983 | 2019-01-10 |
| 1275032252 | Charlotte Simpkins | Nurse's Aide | 462 Se Faith Terrace, Port Saint Lucie, FL 34983 | 2018-02-06 |
| 1124547989 | Alicia Maria Herrero Marzo | Case Manager/Care Coordinator | 749 Nw Orchid St, Port St Lucie, FL 34983 | 2017-09-13 |
| 1922535137 | Superior Living 'llc' | Assisted Living Facility | 496 Southeast Verada, Port St Lucie, FL 34983 | 2017-05-18 |
| 1760931562 | Lisa A Joseph | Registered Nurse | 1602 Se Sandia Dr, Psl, FL 34983 | 2016-09-22 |
| 1891146270 | Janet Bayramyan | Counselor | 453 Nw Dover Ct, Port St Lucie, FL 34983 | 2016-06-27 |
| 1033565650 | Jennifer J Ramos | Physician Assistant | 1581 Sw Bayshore Blvd, Port St Lucie, FL 34983 | 2016-05-12 |
| 1659741379 | Amy Mae Dipalma | Physical Therapy Assistant | 5238 Nw Rugby Dr, Port St Lucie, FL 34983 | 2015-10-07 |
| 1942682406 | Vikash Dahya | Dentist | 499 Sw Prima Vista Blvd, Port St. Lucie, FL 34983 | 2015-06-22 |
| Find all providers in zip 34983 | ||||
| Taxonomy Code | 261QD1600X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Developmental Disabilities |
| An entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184236911 | Borgeline Marie Jina Vilfort | Clinic/Center | 608 Marsh Isle Cir Apt 305, Port Saint Lucie, FL 34952-1457 | 2020-08-21 |
| 1326657586 | Levan Angella Carter | Clinic/Center | 339 Sw Ridgecrest Dr, Port Saint Lucie, FL 34953-5918 | 2020-07-23 |
| 1437790060 | Goosman Saintil | Clinic/Center | 10497 Sw Tibre Ct, Port Saint Lucie, FL 34987-2347 | 2019-10-04 |
| 1295391605 | House of Grace In Psl | Clinic/Center | 1249 Sw Byron St, Port Saint Lucie, FL 34983-2507 | 2019-05-13 |
| 1124597372 | Grace Place Care Center Inc | Clinic/Center | 160 Se Celestia Ct, Port Saint Lucie, FL 34983-2120 | 2018-11-16 |
| 1851885461 | Nelkim Support Services | Clinic/Center | 271 Sw Aubudon Ave, Port Saint Lucie, FL 34984-5029 | 2018-06-18 |
| 1326532029 | Chambers Enterprises Servicing Inc | Clinic/Center | 839 Nw Greenwich Ct, Port Saint Lucie, FL 34983-3403 | 2018-06-18 |
| 1225528094 | Magnolia Home Inc | Clinic/Center | 918 Sw Idol Ave, Port Saint Lucie, FL 34953-6728 | 2018-05-16 |
| 1497262679 | Donna Shipes | Clinic/Center | 1834 Se Mandrake Cir, Port Saint Lucie, FL 34952-6945 | 2018-01-09 |
| 1003322132 | Joy Blakeslee | Clinic/Center | 3100 Columbrina Cir, Port Saint Lucie, FL 34952-3334 | 2017-12-27 |
| Find all providers in PORT SAINT LUCIE | ||||
| City | PORT SAINT LUCIE |
| Zip Code | 34983 |
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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.