PLASTICG LLC (NPI# 1992094684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992094684 |
| Entity Type | Organization |
| Organization Name | PLASTICG LLC |
| Practice Address |
4429 Florida National Dr Lakeland FL 33813-1516 |
| Practice Telephone | 8636472200 |
| Practice Fax Number | 8888541888 |
| Mailing Telephone | 8636472200 |
| Mailing Fax Number | 8888541888 |
| Enumeration Date | 2011-04-03 |
| Last Update Date | 2020-09-22 |
| Authorized Official Name | DR. JACOB GERZENSHTEIN (OWNER) |
| Authorized Official Telephone | 8136163338 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
Allopathic & Osteopathic Physicians | ||
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207PE0005X |
Emergency Medicine Specialization: Undersea and Hyperbaric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 208200000X | Plastic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2082S0099X |
Plastic Surgery Specialization: Plastic Surgery Within the Head and Neck |
Allopathic & Osteopathic Physicians | ||
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3000 Medical Park Dr, Tampa, FL 336134680 | 8136163338 | 8888541888 |
| Street Address |
4429 FLORIDA NATIONAL DR |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-1516 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184785164 | Doran Robert Stark | Plastic Surgery | 4429 Florida National Dr, Lakeland, FL 33813 | 2006-12-13 |
| 1487888731 | Doran R Stark Md Pa | Plastic Surgery | 4429 Florida National Dr, Lakeland, FL 33813-1516 | 2009-05-14 |
| 1710041231 | Jacob Gerzenshtein | Emergency Medicine | 4429 Florida National Dr, Lakeland, FL 33813-1516 | 2006-12-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568025419 | Reinventme, LLC | Surgery | 13696 N Us Highway 441 Ste 100, Lady Lake, FL 32159-6815 | 2019-04-17 |
| 1750854378 | David Gerth Md Pa | Surgery | 4308 Alton Rd Ste 940, Miami Beach, FL 33140-4560 | 2019-01-07 |
| 1588165773 | Deepak Naidu Md, Pa | Surgery | 201 E Kennedy Blvd Ste 410, Tampa, FL 33602-3641 | 2018-02-23 |
| 1194225599 | Joseph Charles Gallagher Jr. | Surgery | 9201 Midnight Pass Rd, Sarasota, FL 34242-2921 | 2018-02-13 |
| 1043729569 | Renee Gasgarth, M.d. P.a. | Surgery | 7300 Sw 62nd Pl Ste 200, South Miami, FL 33143-4800 | 2017-09-27 |
| 1184150625 | Pamela Loftus | Surgery | 4454 Woodfield Blvd, Boca Raton, FL 33434-5310 | 2017-05-03 |
| 1356898324 | Waters Edge Dermatology Global LLC | Surgery | 2601 S Kanner Highway, Stuart, FL 34994 | 2016-09-07 |
| 1629482096 | Jill Swindell | Surgery | 1921 Waldemere St Ste 801, Sarasota, FL 34239-2913 | 2014-06-13 |
| 1205274784 | Melanie L Aya-ay Md Plastic Surgery Pl | Surgery | 17523 N Dale Mabry Hwy, Lutz, FL 33548-4521 | 2013-06-06 |
| 1790123487 | Jason Crespo | Surgery | 1250 Pine Ridge Rd Ste 101c, Naples, FL 34108-8913 | 2013-06-05 |
| Find all providers with the same taxonomy | ||||
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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.