DR. MARK EDWARD DIEBEL (NPI# 1932455136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932455136 |
| Entity Type | Individual |
| Full Name | DR. MARK EDWARD DIEBEL |
| Practice Address |
11945 San Jose Blvd Jacksonville FL 32223-1613 |
| Mailing Address |
11945 San Jose Blvd Ste 300 Jacksonville FL 32223-1627 |
| Practice Telephone | 9043980033 |
| Practice Fax Number | 9043986774 |
| Mailing Telephone | 9043961725 |
| Mailing Fax Number | 9043964893 |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2019-10-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | ME132260 | FL | Allopathic & Osteopathic Physicians |
| Y | 2086S0127X |
Surgery Specialization: Trauma Surgery |
69439-20 | WI | Allopathic & Osteopathic Physicians |
| Street Address |
11945 SAN JOSE BLVD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-1613 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841299625 | Kenneth Michael Sekine | Obstetrics & Gynecology | 11945 San Jose Blvd, 400, Jacksonville, FL 32223-1613 | 2005-07-14 |
| 1801242128 | Brett Daniel O'connor | Optometrist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2016-05-05 |
| 1467797373 | North Florida Surgeons, Pa | Surgery | 11945 San Jose Blvd, #300, Jacksonville, FL 32223-1613 | 2012-12-04 |
| 1023370459 | Baptist Primary Care Inc | Internal Medicine | 11945 San Jose Blvd, Suite 301, Jacksonville, FL 32223-1613 | 2012-06-12 |
| 1417247669 | Florida Woman Care, LLC | Obstetrics & Gynecology | 11945 San Jose Blvd, Bldg 400, Jacksonville, FL 32223-1613 | 2011-04-08 |
| 1508186727 | Sirlys Arcon Rios | Internal Medicine | 11945 San Jose Blvd, Suite 301, Jacksonville, FL 32223-1613 | 2010-06-10 |
| 1396985396 | Colleen Sutton | Physical Therapist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2009-03-03 |
| 1578758132 | Brian Todd Young | Dentist | 11945 San Jose Blvd, Ste. 101, Jacksonville, FL 32223-1613 | 2007-09-07 |
| 1588854335 | Lindsey Beth Kern | Physical Therapist | 11945 San Jose Blvd, Suite 202, Jacksonville, FL 32223-1613 | 2007-07-27 |
| 1730279142 | Jerry Wayne Maida | Ophthalmology | 11945 San Jose Blvd, #102, Jacksonville, FL 32223 | 2006-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| Taxonomy Code | 2086S0127X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Trauma Surgery |
| Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency. |
| Notes: Source: American Board of Surgery, 2007 [1/1/2008: definition added, source added] Additional Resources: http://www.absurgery.org/. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003900952 | Meredith Tinti | Surgery | 3627 University Blvd S Ste 500, Jacksonville, FL 32216-7405 | 2006-10-03 |
| 1477559631 | Mark William White | Surgery | 11945 San Jose Blvd., Bldg 300, Jacksonville, FL 32223-1627 | 2005-06-22 |
| 1568900306 | Neptune Beach Surgical Specialists LLC | Surgery | 3625 University Blvd S, Jacksonville, FL 32216-4207 | 2017-02-01 |
| 1114991049 | Raquel Cruz Bono | Surgery | 2080 Child St, Jacksonville, FL 32214-5005 | 2006-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619422607 | Shawn A. Mcclure Dmd, Md | Surgery | 8755 Sw 57th Pl, Cooper City, FL 33328-5921 | 2016-08-18 |
| 1326434556 | Kyle Leneweaver | Surgery | 5151 N 9th Ave # 305, Pensacola, FL 32504-8721 | 2015-04-14 |
| 1093063869 | Ocala Health Trauma, LLC | Surgery | 205 Se 14th Pl, Ocala, FL 34471-4341 | 2012-08-27 |
| 1912262544 | Injury Management, LLC | Surgery | 4010 Nw 100th Ave, Coral Springs, FL 33065-1549 | 2012-07-10 |
| 1558664987 | Moshe Stav Md Pa | Surgery | 1550 Ponce De Leon Dr, 3200 S. University Dr, Rm 7374, Fort Lauderdale, FL 33316-1324 | 2010-12-07 |
| 1154589786 | Meredith Lynn Shaddix | Surgery | 5153 North 9th Avenue, Suite 305, Pensacola, FL 32504 | 2008-05-30 |
| 1760681225 | Omar Mahmoud El-sheikh | Surgery | 801 E. 6th Street, Suite 602, Panama City, FL 32401-3663 | 2007-07-15 |
| 1689710279 | Thomas Anthony Abbruzzese | Surgery | 1654 Village Center Dr Apt 207, Lakeland, FL 33803-2892 | 2007-01-30 |
| 1194748947 | James Carver Boyd | Surgery | 2280 N 9th Ave, Pensacola, FL 32503-3949 | 2006-07-25 |
| 1154371714 | Ernst E. Vieux, Jr., M.d., P.a. | Surgery | 3000 1st Ave N, St Petersburg, FL 33713-8607 | 2006-05-12 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
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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.