STHORN THATAYATIKOM


Address: 1600 Sw Archer Rd, Box 100371, Gainesville, FL 32610-0296
Phone: 3522945252

STHORN THATAYATIKOM (NPI# 1134394596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2080P0201X Pediatrics
Specialization: Pediatric Allergy/Immunology
ME114556 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL 007647400 05

Office Location

Street Address 1600 SW ARCHER RD
BOX 100371
City GAINESVILLE
State FL
Zip Code 32610-0296

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2080P0201X
Grouping Allopathic & Osteopathic Physicians
Classification Pediatrics
Specialization Pediatric Allergy/Immunology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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
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Competitor

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City GAINESVILLE
Zip Code 32610

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Dataset Information

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.

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