DR. JAROSLAW LUCAS KOBERDA (NPI# 1972548279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972548279 |
| Entity Type | Individual |
| Full Name | DR. JAROSLAW LUCAS KOBERDA |
| Credential | M.D., PHD, NEUROLOGY |
| Practice Address |
4838 Kerry Forest Pkwy Tallahassee FL 32309-2272 |
| Practice Telephone | 8508772802 |
| Practice Fax Number | 8502221383 |
| Mailing Telephone | 8508772802 |
| Mailing Fax Number | 8502221383 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2014-02-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME88946 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BK8550382 | 01 | |
| ECFMG | 04795803 | 01 |
| Street Address |
4838 KERRY FOREST PKWY |
| City | TALLAHASSEE |
| State | FL |
| Zip Code | 32309-2272 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962447268 | J Lucas Koberda, Md, Phd, Neurology, LLC | Psychiatry & Neurology | 4838 Kerry Forest Pkwy, Tallahassee, FL 32309-2272 | 2006-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861090995 | Canopy Counseling & Consulting LLC | Social Worker | 2709-4 Killarney Way, Tallahassee, FL 32309 | 2020-10-12 |
| 1164065975 | Kimberly Michelle Roberts | Technician | 3091 Hawks Landing Drive, Tallahassee, FL 32309 | 2019-10-24 |
| 1558911016 | Valerie Michelle Lewis | Technician | 12514 Moccasin Gap Road, Tallahassee, FL 32309 | 2019-09-17 |
| 1578027686 | Nicole Wolfe | Counselor | 2300 Killearn Center Blvd., Tallahassee, FL 32309 | 2019-01-23 |
| 1134588924 | Matthew Evers | Recreation Therapist | 3383 Aqua Ridge Way, Tallahassee, FL 32309 | 2016-02-22 |
| 1811393499 | Nick Tafuri | Counselor | 823 Sw Greenville Hills Road, Greenville, FL 32309 | 2014-11-10 |
| 1356689699 | Gallop Phedro Franklin II | Pharmacist | 3521 Thomasville, Tallahassee, FL 32309 | 2013-01-22 |
| 1871864157 | Darcee Ann Schmidt | Chiropractor | 3453 Welwyn Way, Tallahassee, FL 32309 | 2012-01-19 |
| 1700051802 | F & G Professional Care Coordinators LLC | Registered Nurse | 3458 Paces Ferry Rd, Tallahassee, FL 32309 | 2008-04-29 |
| 1588672489 | Dennis C Close | Dentist | 2929 Kerry Forest Parkway, Tallahassee, FL 32309 | 2006-08-04 |
| Find all providers in zip 32309 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104071703 | Edmund Molis | Psychiatry & Neurology | 904 Hillcrest Ct, Tallahassee, FL 32308-5060 | 2008-11-24 |
| 1558467431 | Richard E Blackburn | Psychiatry & Neurology | 2868 Mahan Dr, Suite 5, Tallahassee, FL 32308-5468 | 2006-09-16 |
| 1134196215 | Winston R Ortiz | Psychiatry & Neurology | 1401 Centerville Rd Ste 600, Tallahassee, FL 32308-4675 | 2006-03-07 |
| 1720074610 | Roland Peter Jones | Psychiatry & Neurology | 1401 Oven Park Dr, Suite 201, Tallahassee, FL 32308-7959 | 2005-09-26 |
| 1407315948 | Southern Interventional Pain Center LLC | Psychiatry & Neurology | 1931 Welby Way Ste 4, Tallahassee, FL 32308-4473 | 2019-03-14 |
| 1427324888 | Tara Kimbason | Psychiatry & Neurology | 1401 Centerville Rd Ste 504, Tallahassee, FL 32308-4640 | 2012-03-29 |
| 1841564150 | Gery K Florek Md Pa | Psychiatry & Neurology | 1401 Centerville Rd, Suite 506, Tallahassee, FL 32308-4647 | 2012-03-05 |
| 1497047211 | Danny Estupinan | Psychiatry & Neurology | 1401 Centerville Rd Ste 600, Tallahassee, FL 32308 | 2011-05-12 |
| 1326281940 | Chaowen Chen | Psychiatry & Neurology | 1300 Miccosukee Road, Hospitalist Group, Tallahassee, FL 32308 | 2009-04-13 |
| 1689839698 | Muhammad Salman Siddiqi | Psychiatry & Neurology | 1300 Miccosukee Road, Hospitalists Group, Tallahassee, FL 32308 | 2008-07-20 |
| Find all providers in TALLAHASSEE | ||||
| City | TALLAHASSEE |
| Zip Code | 32309 |
Please comment or provide details below to improve the information on DR. JAROSLAW LUCAS KOBERDA.
| 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.