STHORN THATAYATIKOM (NPI# 1134394596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134394596 |
Entity Type | Individual |
Full Name | STHORN THATAYATIKOM |
Credential | MD |
Practice Address |
1600 Sw Archer Rd Box 100371 Gainesville FL 32610-0296 |
Mailing Address |
Po Box 191 Provider Enrollment Rockland DE 19732-0191 |
Practice Telephone | 3522945252 |
Practice Fax Number | 3522948068 |
Mailing Telephone | 3026516212 |
Mailing Fax Number | 3026514945 |
Enumeration Date | 2008-04-28 |
Last Update Date | 2017-05-03 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080P0201X |
Pediatrics Specialization: Pediatric Allergy/Immunology |
ME114556 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | 007647400 | 05 |
Street Address |
1600 SW ARCHER RD BOX 100371 |
City | GAINESVILLE |
State | FL |
Zip Code | 32610-0296 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669475554 | Walter J Milton | Radiology | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2005-05-24 |
1104427251 | Morgan Elizabeth Gilbert | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-11-05 |
1598365306 | Kristin Renee Lapham | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-30 |
1225638174 | Leigha Fridley | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-29 |
1962000950 | Kelli O'shaughnessy | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-13 |
1053919985 | Amber Lynn Bart | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-13 |
1134726847 | Emily Elizabeth Farhat | Social Worker | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-06 |
1346847944 | Nicholas Scott Duarte | Physician Assistant | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-10-06 |
1922613231 | Trinh Nguyen | Pharmacist | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-09-14 |
1053926501 | Annalise Deboef | Nurse Practitioner | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2020-09-11 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003440660 | Thy Cam Huynh | Occupational Therapist | 1549 Gale Lemerand Dr, Gainesville, FL 32610 | 2020-02-23 |
1093359226 | Lauren Anne Ruddocks | Dentist | University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610 | 2019-10-31 |
1104310549 | Brandon Lucke-wold | Neurological Surgery | 1149 S Newell Dr Deapartment of Neurosurgery Bldg #59, Gainesville, FL 32610 | 2018-06-19 |
1619465754 | Carlos Eduardo Vervloet Sollero | Student in an Organized Health Care Education/Training Program | 1149 Newell Drive, University of Florida, Department of Neurology, Gainesville, FL 32610 | 2018-04-24 |
1811359151 | Ramsha A. Kudia | Internal Medicine | 1549 Gale Lemerand Drive, 3rd Floor, Gainesville, FL 32610 | 2016-03-25 |
1447619937 | Wajdi Mohammed | Dentist | 1395 Center Dr., D8-6, Gainesville, FL 32610 | 2016-02-12 |
1922484344 | Kavan Ashit Gandhi | Dentist | 1395 Center Drive D7-19, Gainesville, FL 32610 | 2015-08-07 |
1972981512 | David Shin | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Road, Fl 1, Rm 1097, Gainesville, FL 32610 | 2015-05-15 |
1669887485 | Alejandro Jose Delgado | Dentist | 1395 Center Drive, University of Florida, College of Dentistry, Gainsville, FL 32610 | 2014-07-01 |
1194167296 | Zain Shahid | Student in an Organized Health Care Education/Training Program | 1600 Sw Archer Rd # Ng-45, Gainesville, FL 32610 | 2013-07-18 |
Find all providers in zip 32610 |
Taxonomy Code | 2080P0201X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Pediatric Allergy/Immunology |
A pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: title modified, definition added, source added] Additional Resources: A Certification of Special Qualifications (CSQ) is issued by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699716605 | Shih-wen Huang | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2006-06-09 |
1487694311 | Suzanne Skoda Smith | Pediatrics | 1600 Sw Archer Road, Box 100371, Gainesville, FL 32610-0371 | 2006-06-08 |
1558356402 | Mutasim N. Abu-hasan | Pediatrics | 1600 Sw Archer Rd, Gainesville, FL 32610-3003 | 2005-09-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1790076115 | South Broward Hospital District | Pediatrics | 1131 N 35th Ave Ste 220, Hollywood, FL 33021-5403 | 2011-04-20 |
1053322586 | Hary T. Katz | Pediatrics | 4123 University Blvd. S., Suite B, Jacksonville, FL 32216 | 2006-08-10 |
1427609080 | University of Miami | Pediatrics | 1580 Nw 10th Ave Fl 1, Miami, FL 33136-1013 | 2019-09-25 |
1598185480 | Camile Ortega | Pediatrics | 16371 Nw 67th Ave, Miami Lakes, FL 33014-6044 | 2014-04-18 |
1548607757 | David Squier Lindsay II | Pediatrics | 12901 Bruce B Downs Blvd, #3130, Tampa, FL 33612-4742 | 2013-05-29 |
1225393556 | Grace Toledo Padron | Pediatrics | 1580 Nw 10th Ave, Miami, FL 33136-1013 | 2012-07-12 |
1598058166 | Shajitha Melethil | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2011-05-16 |
1538303631 | Amy Sarah Feldman | Pediatrics | 3100 Sw 62nd Ave, Miami, FL 33155-3009 | 2009-04-21 |
1437349339 | American Medicine, Inc. | Pediatrics | 817 S University Dr, Suite 106, Plantation, FL 33324-3309 | 2007-07-26 |
1225117138 | Ilene Joy Goldstein | Pediatrics | 10301 Hagen Ranch Rd Ste 760, Boynton Beach, FL 33437-3777 | 2006-11-02 |
Find all providers with the same taxonomy |
City | GAINESVILLE |
Zip Code | 32610 |
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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.