AJ INITIATIVES, LLC (NPI# 1154615326) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154615326 |
| Entity Type | Organization |
| Organization Name | AJ INITIATIVES, LLC |
| Practice Address |
4631 Highlands Place Dr Lakeland FL 33813-2160 |
| Practice Telephone | 8635217105 |
| Enumeration Date | 2011-06-06 |
| Last Update Date | 2016-09-09 |
| Authorized Official Name | JORDAN ECKERT (PRESIDENT) |
| Authorized Official Telephone | 8635217105 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
Allopathic & Osteopathic Physicians | ||
| Y | 246ZC0007X |
Specialist/Technologist, Other Specialization: Surgical Assistant |
ME72650 | FL | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 011160100 | 05 |
| Street Address |
4631 HIGHLANDS PLACE DR |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 246ZC0007X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Specialist/Technologist, Other |
| Specialization | Surgical Assistant |
| A surgical assistant is a skilled practitioner who has undergone formalized education and training as a surgical assistant. The surgical assistant performs surgical functions that include, but are not limited to: retracting, manipulating, suturing, clamping, cauterizing, litigating, and tying tissue; suctioning, irrigating and sponging; positioning the patient; closure of body planes and skin; and participating in hemostasis and volume replacement. Surgical assistants are certified and registered or licensed by the state, or, in states without licensure, certified as surgical assistants by completing appropriate education and training. |
| Notes: Source: Association of Surgical Assistants, 2014. [7/1/2014: title modified, definition modified] http://www.surgicalassistant.org/index.php/surgical-assisting Additional Resources: National Surgical Assistant Association, www.nsaa.net. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154952075 | Orlando Mogollon | Specialist/Technologist, Other | 4560 Williamstown Blvd, Lakeland, FL 33810-2738 | 2020-01-29 |
| 1851837272 | Ruslan Khamitov | Specialist/Technologist, Other | 4619 Crestview Ln, Lakeland, FL 33813-2415 | 2017-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275349 | Ydalina Inmaculada Coste Jimenez | Specialist/Technologist, Other | 6817 College Ct Apt 103, Davie, FL 33317-7169 | 2020-11-07 |
| 1508467374 | Anthony Arias Bravo | Specialist/Technologist, Other | 2380 Fairmont Ave, Miramar, FL 33025-3818 | 2020-11-06 |
| 1831798206 | Yanosit Garcia | Specialist/Technologist, Other | 7945 W 31st Ct, Hialeah, FL 33018-3852 | 2020-10-18 |
| 1043819485 | Vivian Martin | Specialist/Technologist, Other | 3401 Sw 10th St Apt 4, Miami, FL 33135-4431 | 2020-10-17 |
| 1891394243 | Tami Coromoto Fort | Specialist/Technologist, Other | 3433 Garden Ave Apt 4, Miami Beach, FL 33140-3847 | 2020-10-17 |
| 1144829581 | Diana Carolina Villalba Pena | Specialist/Technologist, Other | 555 S Luna Ct Apt 111, Hollywood, FL 33021-7564 | 2020-10-17 |
| 1871192211 | Luis Enrique Perez Sanchez | Specialist/Technologist, Other | 15411 Sw 77th Circle Ln Apt 205, Miami, FL 33193-1823 | 2020-10-17 |
| 1598376493 | Melissa Croskey | Specialist/Technologist, Other | 7271 Bucks Ford Dr, Riverview, FL 33578-8379 | 2020-08-13 |
| 1114545498 | Genesis Navas | Specialist/Technologist, Other | 1330 Coral Way Ste 306, Miami, FL 33145-2945 | 2020-07-13 |
| 1629696786 | Indhira Y Pena | Specialist/Technologist, Other | 20 Commodore Dr Apt 114, Plantation, FL 33325-2676 | 2020-07-06 |
| Find all providers with the same taxonomy | ||||
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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.