FRESH START PRIVATE FLORIDA (NPI# 1003166307) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003166307 |
| Entity Type | Organization |
| Organization Name | FRESH START PRIVATE FLORIDA |
| Practice Address |
1415 Panther Ln Naples FL 34109-7874 |
| Practice Telephone | 2395916240 |
| Mailing Telephone | 2395916240 |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2012-09-13 |
| Authorized Official Name | TIMOTHY JON JACKOBOICE (CEO) |
| Authorized Official Telephone | 2395916240 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| Street Address |
1415 PANTHER LN |
| City | NAPLES |
| State | FL |
| Zip Code | 34109-7874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619947801 | Alan Kyle Hagstrom | Anesthesiology | 1415 Panther Ln, Naples, FL 34109-7874 | 2006-01-23 |
| 1013428002 | Kent Christian Fenner | Hearing Instrument Specialist | 1415 Panther Ln, Naples, FL 34109-7874 | 2017-10-17 |
| 1720522923 | Jules A. Kiefer Jr. | Audiologist | 1415 Panther Ln, Naples, FL 34109-7874 | 2016-12-07 |
| 1659829349 | Castle Healthcare Services, Inc | Home Health | 1415 Panther Ln, Suite 329, Naples, FL 34109-7874 | 2016-09-12 |
| 1093164063 | Cognizant Health LLC | Psychiatry & Neurology | 1415 Panther Ln, Naples, FL 34109-7874 | 2016-06-09 |
| 1730593583 | Press Psychology, LLC | Psychologist | 1415 Panther Ln, Suite 218, Naples, FL 34109-7874 | 2014-06-19 |
| 1336550672 | Judith Spina | Hearing Instrument Specialist | 1415 Panther Ln, Suite305, Naples, FL 34109-7874 | 2014-05-08 |
| 1255759221 | Florida Healthcare Enterprises, Inc. | Home Health | 1415 Panther Ln, Naples, FL 34109-7874 | 2014-04-07 |
| 1720404023 | Connect Hearing, Inc. | Audiologist | 1415 Panther Ln, Naples, FL 34109-7874 | 2014-03-11 |
| 1912266016 | Anne H Loughridge, Speech-language Pathologist, Pl | Speech-Language Pathologist | 1415 Panther Ln, Suite 240, Naples, FL 34109-7874 | 2012-05-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407325467 | Dah Therapies LLC | Clinic/Center | 4750 Aston Gardens Way, Therapy Room, Second Floor, Naples, FL 34109 | 2018-11-20 |
| 1003302712 | Ocuflow Doppler LLC | Radiology | 1855 Veterans Park Drive, Naples, FL 34109 | 2018-07-05 |
| 1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
| 1497257968 | Neuro-tech Inc | Behavioral Analyst | 5687 Naples Blvd Suite A, Naples, FL 34109 | 2018-03-01 |
| 1407302177 | Kendria Brown | Behavioral Analyst | 10641 Airport Pulling Road, Naples, FL 34109 | 2016-08-31 |
| 1255789368 | Ideal Image | Specialist | 1485 Pine Ridge Road Unit #1, Naples, FL 34109 | 2016-05-31 |
| 1790153062 | Lee Memorial Health System | Pharmacy | 3361 Pine Ridge Rd, Suite 100, Naples, FL 34109 | 2015-09-03 |
| 1922400340 | North Naples Pediatric Center | Pediatrics | 9160 Galleria Court, Naples, FL 34109 | 2014-09-17 |
| 1720326978 | Evan Michael Asay | Occupational Therapist | 1865 Veterans Park Drive, Suite 101, Naples, FL 34109 | 2013-01-23 |
| 1942599436 | Anchors Away Medical Corp. | Internal Medicine | 1495 Pine Ridge Rd., Suite 4, Naples, FL 34109 | 2011-04-05 |
| Find all providers in zip 34109 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1700443520 | American Detox and Wellness Center | Clinic/Center | 12150 Cortez Blvd, Brooksville, FL 34613-5575 | 2019-05-28 |
| 1982268058 | M.a.t. of The Palm Beaches LLC | Clinic/Center | 321 Northlake Blvd Ste 116, North Palm Beach, FL 33408-5410 | 2019-04-24 |
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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.