Jonathan D Black (NPI# 1700106184, PAC ID# 5597087726) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GYNECOLOGICAL ONCOLOGY.
| Nation Provider ID (NPI) | 1700106184 |
| PAC ID by PECOS | 5597087726 |
| Professional Enrollment ID | I20171229001372 |
| Full Name | Jonathan D Black |
| Organization Legal Name | VITALMD GROUP HOLDING LLC |
| Address |
12741 Miramar Pkwy Suite 302 Miramar FL 33027-2905 |
| Phone Number | 9546029723 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | GYNECOLOGICAL ONCOLOGY |
| Secondary Specialties | OBSTETRICS/GYNECOLOGY |
| Group Practice PAC ID | 8921091786 |
| Number of Group Practice Members | 387 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100281 | MEMORIAL HOSPITAL WEST |
| 100285 | MEMORIAL HOSPITAL MIRAMAR |
| 100167 | PLANTATION GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 3225 Aviation Ave, Suite 700, Miami, FL 33133-4741 | 3052734641 | VITALMD GROUP HOLDING LLC |
| 12741 Miramar Pkwy, Suite 302, Miramar, FL 33027-2905 | 9546029723 | VITALMD GROUP HOLDING LLC |
| 600 S Pine Island Rd, The Center for Gynecologic Oncology LLC, Plantation, FL 33324-3166 | 9546029723 | VITALMD GROUP HOLDING LLC |
| Organization Legal Name | VITALMD GROUP HOLDING LLC |
| Physicians | 416 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tionnei A Knight | Nurse Practitioner | Vitalmd Group Holding LLC | 2964 N State Rd 7, 320 Fern Taisenchoy Bent Md LLC, Margate, FL 33063-5715 |
| Marcela J Torres | Obstetrics/gynecology | Vitalmd Group Holding LLC | 4100 Hollywood Blvd, Suite 2, Hollywood, FL 33021-6778 |
| Stacey L Mckinnon | Nurse Practitioner | Vitalmd Group Holding LLC | 769 N Clyde Morris Blvd, Ob Gyn Health Center of Volusia LLC, Daytona Beach, FL 32114-1493 |
| Timothy P Wu | Dermatology | Vitalmd Group Holding LLC | 4060 Sheridan St, Suite C, Hollywood, FL 33021-3559 |
| Victoria L Bedell | Obstetrics/gynecology | Vitalmd Group Holding LLC | 8900 Sw 117th Ave, 207b Janet Gersten Md LLC, Miami, FL 33186-2155 |
| Masha Sachenko | Obstetrics/gynecology | Vitalmd Group Holding LLC | 6853 Sw 18th St, Suite 301, Boca Raton, FL 33433-7056 |
| Sandra L Aponte | Pathology | Vitalmd Group Holding LLC | 2931 Coral Way, Medipath Pathology Services, Miami, FL 33145-3201 |
| Whitney E Shoemaker | Orthopedic Surgery | Vitalmd Group Holding LLC | 598 Sterthaus Dr, Ormond Beach, FL 32174-5128 |
| Ran Huo | Dermatology | Vitalmd Group Holding LLC | 14932 Pines Blvd, Pembroke Pines, FL 33027-1213 |
| Paola A Bordoni | Obstetrics/gynecology | Vitalmd Group Holding LLC | 9595 N Kendall Dr, 103 Ob and Gyn Associates of Kendall LLC, Miami, FL 33176-1990 |
| Street Address |
12741 MIRAMAR PKWY SUITE 302 |
| City | MIRAMAR |
| State | FL |
| Zip | 33027-2905 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashok V.s. Kumar | Hematology/oncology | 21st Century Oncology, LLC | 12741 Miramar Pkwy, Suite 306, Miramar, FL 33027-2905 |
| Gabriel H Domenech | Medical Oncology | 21st Century Oncology, LLC | 12741 Miramar Pkwy, Suite 306, Miramar, FL 33027-2905 |
| Yavir M Escovar | Internal Medicine | 12741 Miramar Pkwy, Suite 104, Miramar, FL 33027-2904 | |
| Emery I Salom | Gynecological Oncology | Vitalmd Group Holding LLC | 12741 Miramar Pkwy, Suite 302, Miramar, FL 33027-2905 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dana M Levinson | Family Medicine | South Broward Hospital District | 17011 Pines Blvd, Pembroke Pines, FL 33027-1003 |
| Neal M Bullock | Podiatry | 17013 Pines Blvd, Pembroke Pines, FL 33027-1003 | |
| David L Andrisani | Family Medicine | 15800 Pines Blvd, Suite 329, Pembroke Pines, FL 33027-1212 | |
| Renee T Neely | Audiologist | 15800 Pines Blvd, Suite 347, Pembroke Pines, FL 33027-1212 | |
| Ran Huo | Dermatology | Vitalmd Group Holding LLC | 14932 Pines Blvd, Pembroke Pines, FL 33027-1213 |
| Ladan Pourmasiha | Osteopathic Manipulative Medicine | Criticare Clinics Inc | 15885 Pines Blvd, Pembroke Pines, FL 33027-1220 |
| Jorge Carriazo Isasi | Family Medicine | Criticare Clinics Inc | 15885 Pines Blvd, Pembroke Pines, FL 33027-1220 |
| Reynold Duarte Martinez | Internal Medicine | Criticare Clinics Inc | 15885 Pines Blvd, Pembroke Pines, FL 33027-1220 |
| Inemesit Abia | Emergency Medicine | Criticare Clinics Inc | 15885 Pines Blvd, Pembroke Pines, FL 33027-1220 |
| Samantha Cahen | Nurse Practitioner | Criticare Clinics Inc | 15885 Pines Blvd, Pembroke Pines, FL 33027-1220 |
| Find all physicians in zip 33027 | |||
| City | MIRAMAR |
| Zip Code | 33027 |
| Specialty | GYNECOLOGICAL ONCOLOGY |
| City + Specialty | MIRAMAR + GYNECOLOGICAL ONCOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.