DR. EDWARD H. BECKER III (NPI# 1124162789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1124162789 |
Entity Type | Individual |
Full Name | DR. EDWARD H. BECKER III |
Credential | MD |
Practice Address |
615 Vonderburg Dr Brandon FL 33511-5972 |
Practice Telephone | 8136842663 |
Practice Fax Number | 8136859178 |
Mailing Telephone | 8136842663 |
Mailing Fax Number | 8136859178 |
Enumeration Date | 2007-02-16 |
Last Update Date | 2013-12-17 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgery | C10010063 | DE | Allopathic & Osteopathic Physicians |
Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ME 116897 | FL | Allopathic & Osteopathic Physicians |
N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
A115181 | CA | Allopathic & Osteopathic Physicians |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
State | Issuer | Identifier | Type Code |
---|---|---|---|
DE | 1124162789 | 05 | |
AMERIHEALTH | 3884073000 | 01 | |
AETNA | 9185848 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417979972 | Edward J Becker | Dentist | 15600 Washington Ave, Ste. A, San Lorenzo, CA 94580-1467 | 2006-07-24 |
1720327323 | Edward Becker | Ophthalmology | 3501 Silverside Rd, Naamans Bldg., Wilmington, DE 19810-4910 | 2013-02-04 |
1457620080 | Edward Becker | Pharmacist | 2840 Alexandria Pike, Highland Heights, KY 41076-1523 | 2011-12-28 |
1932485562 | Edward D Becker | Pharmacist | 2203 Beechmont Ave, Cincinnati, OH 45230 | 2011-10-27 |
1821235045 | Edward Becker | Social Worker | 23811 Chagrin Blvd, Suite 310, Beachwood, OH 44122-5525 | 2009-01-09 |
1962515858 | Edward V Becker | Dermatology | 2255 Ygnacio Valley Rd, #b-1, Walnut Creek, CA 94598 | 2006-08-16 |
1194703223 | Edward Rene Becker | Urology | 3347 State Road 7, Suite 101, Wellington, FL 33449-8095 | 2006-01-09 |
Street Address |
615 VONDERBURG DR |
City | BRANDON |
State | FL |
Zip Code | 33511-5972 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1306830955 | William Thomas Romaniello IIi | Specialist/Technologist | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2005-09-09 |
1619584224 | Lucy Harris | Physician Assistant | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2020-09-28 |
1326680703 | Mckenzie Moore | Specialist/Technologist | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2019-10-17 |
1699317925 | Dennis Rinaldi | Physical Therapist | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2019-10-08 |
1588137921 | Chelsea Hill | Physician Assistant | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2019-01-08 |
1801304126 | Morgan Leigh Williams | Physician Assistant | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2018-01-22 |
1437505179 | Patrick Donovan | Podiatrist | 615 Vonderburg Dr, Brandon, FL 33511 | 2016-05-12 |
1134462906 | Matthew Richard Moralle | Orthopaedic Surgery | 615 Vonderburg Dr, Brandon, FL 33511 | 2013-03-31 |
1356620330 | Thao Phuong Nguyen | Orthopaedic Surgery | 615 Vonderburg Dr, Brandon, FL 33511 | 2011-08-09 |
1093037848 | Luz Maritza Rayburn | Physical Therapist | 615 Vonderburg Dr, Brandon, FL 33511-5972 | 2010-02-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295367555 | Ability Beyond Measures LLC. | Clinic/Center | 2705 Isabella Valley Court, Brandon, FL 33511 | 2020-02-05 |
1831744655 | Brandon Modern Dentistry, Pa | Dentist | 971 E. Bloomingdale Avenue, Brandon, FL 33511 | 2019-08-08 |
1487208922 | Heart and Vascular Center of Brandon, Pllc | Internal Medicine | 511 Medical Oaks Ave., Brandon, FL 33511 | 2019-08-01 |
1841842895 | Rebecca Harrelson | Counselor | 915 Oakfield Drive, Suite E, Brandon, FL 33511 | 2019-07-10 |
1043779713 | Cheryl Diane Hart | Nurse Practitioner | 888 S Parsons Ave., Brandon, FL 33511 | 2019-03-13 |
1306303177 | Paula J Buchwald | Nurse Practitioner | 888 S. Parsons Ave, Brandon, FL 33511 | 2019-02-27 |
1063993996 | Ashlee Marie Shevchenko | Speech-Language Pathologist | 602 Vondeburg Dr, Suite 201, Brandon, FL 33511 | 2018-08-28 |
1275023012 | Ava Cares, LLC | Assisted Living Facility | 3005 Bell Shoals Rd., Brandon, FL 33511 | 2018-05-17 |
1346738705 | Tampa Psychology Group | Psychologist | 1463 Oakfield Dr Ste 109, Brandon, FL 33511 | 2018-05-01 |
1760982987 | Suresh Lama Tamang | Counselor | 510 Vonderburg Dr, Suite# 301, Brandon, FL 33511 | 2018-02-14 |
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Taxonomy Code | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285920454 | Neil Kumar | Orthopaedic Surgery | 721 W Robertson St Ste 102, Brandon, FL 33511 | 2011-06-25 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801401021 | Ortho Florida, LLC | Orthopaedic Surgery | 17425 7th St Ste 560174, Montverde, FL 34756-3206 | 2020-09-14 |
1801429022 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Creek Rd Ste 202, Ft Lauderdale, FL 33309-1858 | 2020-02-17 |
1750913141 | Tyrance Orthopedics and Sports Medicine | Orthopaedic Surgery | 1620 S Congress Ave Ste 201, Palm Springs, FL 33461-2128 | 2020-02-04 |
1255979076 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Crk Rd Ste 202, Fort Lauderdale, FL 33309-1858 | 2019-12-11 |
1730740218 | Baptist Physician Group LLC | Orthopaedic Surgery | 133 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1644 | 2019-06-25 |
1164984720 | Ortho Florida, LLC | Orthopaedic Surgery | 21097 Ne 27th Ct Ste 590, Aventura, FL 33180-1246 | 2019-04-03 |
1578043998 | Bahri Orthopedics Institute | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-08-15 |
1154834489 | Dorothy Richardson | Orthopaedic Surgery | 1120 W Lakeshore Dr, Clermont, FL 34711-2936 | 2017-11-08 |
1225541790 | Ortho Florida, LLC | Orthopaedic Surgery | 3702 Washington St Ste 202, Hollywood, FL 33021-8283 | 2017-11-07 |
1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
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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.