JARED WISHIK (NPI# 1922460161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922460161 |
| Entity Type | Individual |
| Full Name | JARED WISHIK |
| Credential | M.D. |
| Practice Address |
5200 Seminole Blvd St Petersburg FL 33708-3356 |
| Mailing Address |
4651 Van Dyke Rd Lutz FL 33558-4880 |
| Practice Telephone | 8133211786 |
| Practice Fax Number | 8133211787 |
| Mailing Telephone | 8133211786 |
| Mailing Fax Number | 8133211787 |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2020-07-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | M144461 | FL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 125069551 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1740 W Taylor St, Chicago, IL 606127232 | 8666002273 | |
| 500 Vonderburg Dr Ste 115w, Brandon, FL 335115969 | 8133211786 | 8133211787 |
| Street Address |
5200 SEMINOLE BLVD |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33708-3356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922195957 | Jeri Quirk | Counselor | 5200 Seminole Blvd, Suite K, St Petersburg, FL 33708-3378 | 2006-10-10 |
| 1316327877 | Tiffani Botts | Physician Assistant | 5200 Seminole Blvd, St Petersburg, FL 33708 | 2015-05-31 |
| 1902173420 | Jennifer Michelle Crews | Physician Assistant | 5200 Seminole Blvd, St Petersburg, FL 33708 | 2011-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023580545 | Caryn Lee Jackson-costello | Technician | 229h Medallion Boulevard, Madeira Beach, FL 33708 | 2018-12-21 |
| 1033566112 | Lori Ganim | Radiologic Technologist | 10000 Bay Pines Blvd North, St Petersburg, FL 33708 | 2016-05-19 |
| 1073929634 | Blake Burnett | Student in an Organized Health Care Education/Training Program | 9200 113th Street, Saint Petersburg, FL 33708 | 2014-07-03 |
| 1568876084 | Lori R Hassinger Pa | Optometrist | 10127 Bay Pines Blvd, Saint Petersburg, FL 33708 | 2014-06-12 |
| 1043596927 | Elizabeth Wedman-st. Louis | Dietitian, Registered | 17920 Gulf Blvd, Ste 606, Redington Shores, FL 33708 | 2011-10-24 |
| 1033492301 | Irina S Solonenko | Pharmacist | 674 E Welch Causeway, Madeira Beach, FL 33708 | 2011-09-23 |
| 1962630277 | Rebekah Anne Smith | Optometrist | 15037 Madeira Way, Madeira Beach, FL 33708 | 2009-06-25 |
| 1952535973 | Ronald A Luscomb | Nurse Practitioner | 16110 Redington Drive, Redington Beach, FL 33708 | 2009-05-05 |
| 1679753933 | We Care Home Health Inc | Home Health | 10911 53rd Av No, St Petersburg, FL 33708 | 2007-11-05 |
| 1740408798 | The Hoffman Clinic, P.a. | Acupuncturist | 13495 Gulf Boulevard, Madeira Beach, FL 33708 | 2007-04-23 |
| Find all providers in zip 33708 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255981338 | Alexandra Coad | Dermatology | 2191 9th Ave N Ste 100, St Petersburg, FL 33713-7147 | 2019-09-19 |
| 1417421066 | Yvonne L Bruner | Dermatology | 4307 71st St N, St Petersburg, FL 33709-4513 | 2019-01-16 |
| 1396126744 | Katarina Rose Kesty | Dermatology | 100 40th Ave N, St Petersburg, FL 33703-6125 | 2015-06-11 |
| 1619105145 | Dermatology Partners of Saint Petersburg, LLC | Dermatology | 501 Mlk Jr St S, St Petersburg, FL 33705-1814 | 2009-06-23 |
| 1124215199 | John F Kirk Md, Pa | Dermatology | 4444 Central Ave, St Petersburg, FL 33711-1142 | 2007-10-03 |
| 1316139249 | Elizabeth Arrington | Dermatology | 1530 Dr Martin Luther King Jr St N, St Petersburg, FL 33704-4202 | 2007-08-14 |
| 1063517050 | Wanda M Boote | Dermatology | 2060 5th Ave N, St Petersburg, FL 33713-8012 | 2006-09-14 |
| 1689688830 | Carol Jeanne Sims-robertson | Dermatology | 2100 Dr Martin Luther King Jr St N, Divine Dermatology Pllc, St Petersburg, FL 33704-3264 | 2006-07-27 |
| 1841240462 | Margaret Ann Kelleher | Dermatology | 6110 Dr Martin Luther King Jr St N, St Petersburg, FL 33703-1142 | 2006-05-12 |
| 1609840487 | Margaret H Rinker | Dermatology | 6450 38th Ave N Ste 330, St Petersburg, FL 33710-1649 | 2006-02-16 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33708 |
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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.