DR. JACQUELYN H NYSTROM (NPI# 1083818553) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083818553 |
| Entity Type | Individual |
| Full Name | DR. JACQUELYN H NYSTROM |
| Credential | M.D. |
| Practice Address |
9975 Tavistock Lake Blvd Suite 220 Orlando FL 32827-7559 |
| Practice Telephone | 4079307901 |
| Practice Fax Number | 4079307806 |
| Mailing Telephone | 4079307901 |
| Mailing Fax Number | 4079307806 |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2015-02-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME94368 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
9975 TAVISTOCK LAKE BLVD SUITE 220 |
| City | ORLANDO |
| State | FL |
| Zip Code | 32827-7559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710515408 | Guru Nandha Raja Chinnaraj | Student in an Organized Health Care Education/Training Program | 6850 Lake Nona Boulevard, Orlando, FL 32827 | 2020-03-30 |
| 1669030037 | Makris Dental LLC | Dentist | 13250 Narcoossee Road, Orlando, FL 32827 | 2019-05-31 |
| 1174016265 | Heather Marinello | Audiologist | Orlando Va Medical Center- Audiology Department, 13800 Veterans Way, Orlando, FL 32827 | 2018-06-13 |
| 1316445471 | Adventist Health System/sunbelt Inc. | Clinic/Center | 9637 Lake Nona Village Pl., Orlando, FL 32827 | 2018-01-24 |
| 1578077335 | Seyla Counseling Inc | Psychologist | 6900 Tanrsrock Lake Blvd Suite 400, Orlando, FL 32827 | 2017-11-30 |
| 1013426188 | Valerie Anne Farrell | Social Worker | 13800 Veteran's Way, Bldg 9, Orlando, FL 32827 | 2017-09-21 |
| 1568981256 | Aneal Ansar Ahmed | Pharmacist | 6550 Sanger Road, University of Florida, Orlando, FL 32827 | 2017-09-13 |
| 1083132575 | Lindey Christine Bartolucci | Psychologist | 13800 Veterans Way Fl 2, Orlando, FL 32827 | 2017-09-05 |
| 1396299087 | Leah Sheehey-hampton | Counselor | 600 Tavistock Lakes Blvd, Suite 400, Orlando, FL 32827 | 2016-08-10 |
| 1972919272 | Scott Sakowitz | Dentist | 9161 Narcoossee Rd Ste 105b, Orlando, FL 32827 | 2014-07-08 |
| Find all providers in zip 32827 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609484336 | Rw Family Practice & Preventive Care, LLC. | Family Medicine | 6735 Conroy Rd Ste 418, Orlando, FL 32835-3566 | 2020-07-20 |
| 1750906855 | Ashleigh Kittel | Family Medicine | 646 W Smith St Unit 506, Orlando, FL 32804-5383 | 2020-06-15 |
| 1962031633 | Annuel Lebrun | Family Medicine | 5317 Curry Ford Rd Apt K202, Orlando, FL 32812-7209 | 2020-04-05 |
| 1427699610 | Orlando Wellness | Family Medicine | 2909 N Orange Ave Ste 112a, Orlando, FL 32804-4639 | 2019-09-30 |
| 1558912006 | Ork Medical | Family Medicine | 2441 South Hiawassee Road, Orlando, FL 32835 | 2019-09-26 |
| 1649820267 | Florida Advanced Primary, Urgent & Holistic Medicine LLC | Family Medicine | 8931 Heritage Bay Cir, Orlando, FL 32836-5026 | 2019-09-16 |
| 1023664968 | Vera Lee Ahmad | Family Medicine | 18731 Sabal St, Orlando, FL 32833-5268 | 2019-08-15 |
| 1457912081 | Adventist Health System/sunbelt, Inc. | Family Medicine | 9637 Lake Nona Village Pl, Orlando, FL 32827-7319 | 2019-06-25 |
| 1639737273 | Adedeji A Onitiri | Family Medicine | 11750 E Colonial Dr Ste 100, Orlando, FL 32817-4656 | 2019-05-29 |
| 1962068783 | Health & Wellness Place | Family Medicine | 7363 W Colonial Dr, Orlando, FL 32818-6507 | 2019-05-16 |
| Find all providers in ORLANDO | ||||
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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.