CHRISTOPHER DESTEPHANO (NPI# 1073812681) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073812681 |
| Entity Type | Individual |
| Full Name | CHRISTOPHER DESTEPHANO |
| Credential | MD |
| Practice Address |
4500 San Pablo Rd S Jacksonville FL 32224-1865 |
| Practice Telephone | 9049532000 |
| Enumeration Date | 2011-03-22 |
| Last Update Date | 2020-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | ME122894 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4500 SAN PABLO RD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-1865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891799136 | Richard Clarke Agnew | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-06-01 |
| 1427657964 | Brianna Iannarelli | Nurse Anesthetist, Certified Registered | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-24 |
| 1538768981 | Heather Anne Dahlen | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-17 |
| 1578161717 | Szilvia Fortner | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-10 |
| 1265049464 | Carolyn Gonzalez | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-09-30 |
| 1467065748 | Ifeloluwa A Olutola | Family Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-26 |
| 1366055568 | Krina Dipak Vyas | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-26 |
| 1356954911 | Haleigh Diane Shelton | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-24 |
| 1215548805 | Victoria Zeilinger Reams | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-16 |
| 1558971382 | Rachel Marie Hannon | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396108528 | Michelle Melanson | Obstetrics & Gynecology | 14546 Old Saint Augustine Rd Ste 305-311, Jacksonville, FL 32258-5468 | 2016-04-04 |
| 1316387947 | Alexander David Raw | Obstetrics & Gynecology | 1600 W Walnut St Bldg 3, Jacksonville, IL 62650-1136 | 2013-06-27 |
| 1912260613 | Paulami Guha | Obstetrics & Gynecology | 836 Prudential Dr Ste 1600, Jacksonville, FL 32207 | 2012-06-19 |
| 1689963696 | Dawn M Mormak | Obstetrics & Gynecology | 836 Prudential Dr Ste 1506, Jacksonville, FL 32207-8342 | 2011-03-30 |
| 1710210745 | Niamh A Condon | Obstetrics & Gynecology | 653-1 W 8th St # L-17, Jacksonville, FL 32209-6511 | 2009-09-09 |
| 1356531396 | Coastal Ob Gyn and Infertility | Obstetrics & Gynecology | 114a Memorial Dr, Jacksonville, NC 28546-6328 | 2007-07-26 |
| 1871614057 | Aida A. Malonzo | Obstetrics & Gynecology | 1512 Palm Ave, Jacksonville, FL 32207-2916 | 2007-04-03 |
| 1487717864 | Geoffrey Gillen | Obstetrics & Gynecology | 653 W 8th St # L17, Jacksonville, FL 32209-6511 | 2006-12-18 |
| 1306916580 | Jason R Thompson | Obstetrics & Gynecology | 6885 Belfort Oaks Place Ste 210, Jacksonville, FL 32216 | 2006-11-08 |
| 1154400554 | Charles Burk | Obstetrics & Gynecology | 203 Nacogdoches St Ste 210, Jacksonville, TX 75766-2455 | 2006-11-04 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
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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.