DOUGLAS EBERSOLE (NPI# 1972575736) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972575736 |
| Entity Type | Individual |
| Full Name | DOUGLAS EBERSOLE |
| Credential | MD |
| Practice Address |
1600 Lakeland Hills Blvd Lakeland FL 33805 |
| Mailing Address |
1600 Lakeland Hills Blvd Lakeland FL 33805-3019 |
| Practice Telephone | 8636807490 |
| Practice Fax Number | 8662648519 |
| Mailing Telephone | 8636807000 |
| Mailing Fax Number | 8662648519 |
| Enumeration Date | 2006-02-06 |
| Last Update Date | 2020-10-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
ME51795 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1600 LAKELAND HILLS BLVD |
| City | LAKELAND |
| State | FL |
| Zip Code | 33805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316940695 | Watson Clinic LLP | Internal Medicine | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2005-05-31 |
| 1134720261 | Hope Dukes | Family Medicine | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2020-11-04 |
| 1659994259 | Jessica Lynn Garber | Physician Assistant | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2020-05-19 |
| 1427681410 | Paula Suryani Wibowo | Nurse Practitioner | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2020-02-18 |
| 1932739828 | Ashley Duncan | Nurse Anesthetist, Certified Registered | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2020-01-21 |
| 1285273672 | Nicholas Skulimoski | Nurse Anesthetist, Certified Registered | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2020-01-02 |
| 1134779812 | Mallory Bastian | Physician Assistant | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2019-09-16 |
| 1730741356 | Kellie L. Smaidi | Nurse Anesthetist, Certified Registered | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3065 | 2019-07-03 |
| 1982265864 | Alexandra Starzhevskiy | Nurse Practitioner | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2019-06-22 |
| 1548829666 | Ashley Nicole Craig | Nurse Practitioner | 1600 Lakeland Hills Blvd, Lakeland, FL 33805 | 2019-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477188704 | Ernie Tairon Lugo | Nursing Home Administrator | 5210 State Road N 33, Lot 8, Lakeland, FL 33805 | 2020-03-06 |
| 1912546631 | Francis Esperanzate | Physical Therapist | 5070 Menlo Parke Way, Lakeland, FL 33805 | 2019-12-27 |
| 1689232514 | Anointed Touch | Home Health | 617 S Robson Street, Lakeland, FL 33805 | 2019-06-05 |
| 1083160642 | Cherlande Pierre | Chiropractor | 1507 Lakeland Hills Blvd Ste 109, Lakeland, FL 33805 | 2016-09-01 |
| 1992251706 | Damaris Salmeron | Physical Therapy Assistant | 3127 Us Hwy 98 N, Lakeland, FL 33805 | 2016-08-31 |
| 1831589076 | Sarah Mcneill | Pharmacist | 3124 Lakeland Hills Blvd, Lakeland, FL 33805 | 2015-01-26 |
| 1750706479 | Alison M Busby | Counselor | Achievement Academy Inc, 716 E. Bella Vista St, Lakeland, FL 33805 | 2014-03-04 |
| 1174872907 | William Vargas, M.d. P. A. | Anesthesiology | 202 Parkview Place, Lakeland, FL 33805 | 2012-09-07 |
| 1184998056 | Eduardo Francisco Lopez Garcia | Internal Medicine | 135 E First Street, Lakeland, FL 33805 | 2012-02-24 |
| 1255625513 | Navdeep Singh Jassal | Physical Medicine & Rehabilitation | 1417 Lakeland Hills Blvd Ste 201, Lakeland, FL 33805 | 2011-06-04 |
| Find all providers in zip 33805 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548548332 | Zia Rab | Internal Medicine | 1600 Lakeland Hills Blvd, Lakeland, FL 33805-3019 | 2011-07-27 |
| 1790099265 | Wendy Izarnotegui Castillo | Internal Medicine | 4715 S Florida Ave Ste 200, Lakeland, FL 33813 | 2010-07-27 |
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|---|---|---|---|---|
| 1861004277 | Steve Malosky Md LLC | Internal Medicine | 900 Sw Saint Lucie Cres, Stuart, FL 34994-2842 | 2020-08-18 |
| 1881212744 | North Broward Hospital District | Internal Medicine | 817 S University Dr Ste 104, Plantation, FL 33324-3345 | 2020-07-08 |
| 1821612821 | Satish Sivasankaran Md Pa | Internal Medicine | 5340 Gulf Dr Ste 101, New Port Richey, FL 34652-3922 | 2020-06-04 |
| 1699317933 | Abid A Shah Md LLC | Internal Medicine | 5741 Bee Ridge Rd Ste 420, Sarasota, FL 34233-5081 | 2019-10-08 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1205329620 | Central Florida Cardiovascular Imaging Center, LLC | Internal Medicine | 1717 Mayo Dr, Tavares, FL 32778-4307 | 2018-06-11 |
| 1568953511 | Orlando Lopez-fernandez Jr. | Internal Medicine | 2800 Ponce De Leon Blvd Ste 1480, Coral Gables, FL 33134-6921 | 2018-05-25 |
| 1467959668 | Cardiology Practice Pa | Internal Medicine | 5051 Ashington Landing Dr, Tampa, FL 33647-3515 | 2018-04-12 |
| 1619476785 | Synergy Health Group LLC | Internal Medicine | 7828 Collins Grove Rd, Jacksonville, FL 32256-7175 | 2018-02-05 |
| 1114425477 | Cardiac Cin of Miami LLC | Internal Medicine | 2 S Biscayne Blvd Ste 3760c, Miami, FL 33131-1815 | 2018-01-31 |
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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.