DR. JOHN LAIRD MCMULLEN III (NPI# 1891998498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891998498 |
| Entity Type | Individual |
| Full Name | DR. JOHN LAIRD MCMULLEN III |
| Credential | MD |
| Practice Address |
801 E Dixie Ave Suite 104 Leesburg FL 34748-7699 |
| Mailing Address |
734 N 3rd St Suite 115 Leesburg FL 34748-5285 |
| Practice Telephone | 3523652583 |
| Practice Fax Number | 3527286749 |
| Mailing Telephone | 3523652583 |
| Mailing Fax Number | 3527286749 |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2016-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RM1200X |
Internal Medicine Specialization: Magnetic Resonance Imaging (MRI) |
93848 | FL | Allopathic & Osteopathic Physicians |
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
93849 | FL | Allopathic & Osteopathic Physicians |
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
93848 | FL | Allopathic & Osteopathic Physicians |
| N | 202K00000X | Phlebology | ME93848 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | RR MEDICARE RACF | P00656364 | 01 |
| FL | RR MEDICARE LMIV | P00656356 | 01 |
| FL | 000070900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497841506 | John R Mcmullen | Physician Assistant | 333 N 17th Dr, Phoenix, AZ 85007-2423 | 2006-10-05 |
| 1578182085 | John Scott Mcmullen | Pharmacist | 981090 Nebraska Medical Ctr, Omaha, NE 68198-1090 | 2020-04-14 |
| 1831230713 | John George Mcmullen | Social Worker | 1061 Pleasant St, New Bedford, MA 02740-6728 | 2007-02-12 |
| 1982796629 | John Francis Mcmullen | Nurse Anesthetist, Certified Registered | 1400 Vfw Pkwy, West Roxbury, MA 02132-4927 | 2006-09-29 |
| Street Address |
801 E DIXIE AVE SUITE 104 |
| City | LEESBURG |
| State | FL |
| Zip Code | 34748-7699 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831196658 | Anton Serafini | Internal Medicine | 801 E Dixie Ave, Suite 104, Leesburg, FL 34748-7699 | 2005-07-07 |
| 1164728820 | Romil Y Patel | Internal Medicine | 801 E Dixie Ave, Suite 104, Leesburg, FL 34748-7699 | 2011-01-28 |
| 1093033433 | Amir Ali Hameedi | Radiology | 801 E Dixie Ave, Suite 104, Leesburg, FL 34748-7699 | 2010-05-10 |
| 1053405381 | Keith Kastelic | Radiology | 801 E Dixie Ave, Ste 104, Leesburg, FL 34748-7699 | 2006-10-03 |
| 1619074515 | Rohini Sastry Md Pa | Anesthesiology | 801 E Dixie Ave, Suite 107, Leesburg, FL 34748-7699 | 2006-09-20 |
| 1821016882 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 801 E Dixie Ave, Ste 105a, Leesburg, FL 34748-7601 | 2006-07-18 |
| 1649208745 | Robert C Lee | Internal Medicine | 801 E Dixie Ave, Suite 104, Leesburg, FL 34748-7699 | 2006-06-28 |
| 1972558146 | Eze David Uche | Internal Medicine | 801 E Dixie Ave, Suite 107, Leesburg, FL 34748-7699 | 2006-05-24 |
| 1750333480 | Miguel E Gonzalez | Internal Medicine | 801 E Dixie Ave, Suite 101, Leesburg, FL 34748-7699 | 2006-05-17 |
| 1366493702 | George Edward Kainz | Internal Medicine | 801 E Dixie Ave, Suite 104, Leesburg, FL 34748-7601 | 2006-05-12 |
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| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649225715 | Belleview Imaging Center, LLC | Radiology | 2500 Citrus Blvd., Leesburg, FL 34748-3063 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100917 | Emergency and Interventional Specialists, Inc | Radiology | 5626 Gulf Dr Ste 100, New Port Richey, FL 34652-4020 | 2020-09-23 |
| 1548879794 | Vascular Specialist of Venice and Sarasota Pl | Radiology | 6600 University Parkway, #102, Sarasota, FL 34240 | 2020-07-23 |
| 1164060497 | Advanced Vascular Cardiac & Veins, Pllc | Radiology | 7480 Bird Rd Ste 560, Miami, FL 33155-6657 | 2019-12-17 |
| 1801437041 | Premier Interventional & Diagnostic Radiology, Corp | Radiology | 8495 Sw 56th St, Miami, FL 33155-5426 | 2019-09-30 |
| 1003476169 | Hss-florida Physicians LLC | Radiology | 1395 S State Road 7 Ste 410, Wellington, FL 33414-9327 | 2019-06-19 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1972006351 | Minimally Invasive Vascular, Inc | Radiology | 2720 Us Highway 1 S Ste C, St Augustine, FL 32086-6301 | 2018-03-13 |
| 1124530761 | Radiology & Imaging Specialists of Lakeland, Pa | Radiology | 313 W Bass St, Kissimmee, FL 34741-5011 | 2017-11-03 |
| 1942727516 | Inspired Interventional Radiology Services LLC | Radiology | 11011 Sheridan St Ste 102, Hollywood, FL 33026-1501 | 2017-08-24 |
| 1386004901 | Precision Medical Imaging and Therapeutic Institute LLC | Radiology | 2540 Green Forest Ln, Suite #101, Lutz, FL 33558-5388 | 2016-02-24 |
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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.