FLORIDA DIGESTIVE AND LIVER SPECIALISTS PA (NPI# 1215154661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215154661 |
| Entity Type | Organization |
| Organization Name | FLORIDA DIGESTIVE AND LIVER SPECIALISTS PA |
| Practice Address |
25 Silver Palm Ave Melbourne FL 32901-3177 |
| Practice Telephone | 3217254150 |
| Practice Fax Number | 3217331335 |
| Mailing Telephone | 3217254150 |
| Mailing Fax Number | 3217331335 |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2010-09-15 |
| Authorized Official Name | LIZ MAZARA (BILLING DEPARTMENT) |
| Authorized Official Telephone | 3217525210 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
ME79573 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
25 SILVER PALM AVE |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32901-3177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700983863 | Shireen F Gadallah | Internal Medicine | 25 Silver Palm Ave, Suite B, Melbourne, FL 32901-3177 | 2006-09-20 |
| 1083094544 | Samantha Nicole Robertson | Nurse Practitioner | 25 Silver Palm Ave, Melbourne, FL 32901-3177 | 2015-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1124676820 | Abbi Dell Lee | Behavioral Analyst | 3251 Engineering St, Melbourne, FL 32901 | 2019-08-27 |
| 1750856878 | Jeffrey Michael Cavanagh | Behavior Technician | 3251 Engineering Street, Melbourne, FL 32901 | 2018-10-04 |
| 1740766021 | Amanda Miller | Behavior Technician | 1885 W Hibiscus Blvd, Melbourne, FL 32901 | 2018-07-19 |
| 1396244406 | Dragen II LLC | Urology | 129 W Hibiscus Blvd Ste D, Melbourne, FL 32901 | 2018-02-03 |
| 1225550692 | Cabrit Psychotherapy Services LLC | Marriage & Family Therapist | 100 Rialto Place, Suite 700, Melbourne, FL 32901 | 2017-07-07 |
| 1487188058 | Project Response, Inc. | Clinic/Center | 747 S. Apollo Boulevard, Melbourne, FL 32901 | 2017-04-20 |
| 1184174575 | Paulette Swanson | Physical Therapist | 611 East Sheridan Rd, Melbourne, FL 32901 | 2016-10-10 |
| 1841747839 | Nicholas Wilson | Social Worker | 3661 S. Babcock St., Melbourne, FL 32901 | 2016-09-07 |
| 1467804278 | Nickolas Hetherington | Occupational Therapist | 1900 S Harbor City Blvd Ste 108, Melbourne, FL 32901 | 2016-07-05 |
| Find all providers in zip 32901 | ||||
| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700983863 | Shireen F Gadallah | Internal Medicine | 25 Silver Palm Ave, Suite B, Melbourne, FL 32901-3177 | 2006-09-20 |
| 1467556456 | Peter A Koretsky | Internal Medicine | 2955 Pineda Plaza Way Ste 115, Melbourne, FL 32940-7306 | 2006-09-11 |
| 1275519548 | Scott Seminer | Internal Medicine | 1334 Valentine St, Melbourne, FL 32901-3128 | 2005-12-19 |
| 1164406500 | Jeremiah Paul Donovan | Internal Medicine | 6235 Anello Dr, Melbourne, FL 32940 | 2005-11-30 |
| 1922081983 | Athan P Kartsonis | Internal Medicine | 1301 Hickory St, Melbourne, FL 32901-3223 | 2005-11-23 |
| 1861483810 | Glenn David Gardner | Internal Medicine | 1324 Valentine St, Melbourne, FL 32901-3128 | 2005-10-31 |
| 1316937535 | Kaseng Derek Chan-pong | Internal Medicine | 1223 Gateway Dr Ste B, Melbourne, FL 32901-2607 | 2005-10-27 |
| 1114917655 | Charles A Farrington | Internal Medicine | 1223 Gateway Dr Ste 2b, Melbourne, FL 32901-2607 | 2005-10-26 |
| 1700870847 | Mark Douglas Hughes | Internal Medicine | 8725 N Wickham Rd Ste 200, Melbourne, FL 32940-2240 | 2005-09-06 |
| 1033101985 | Martin E Avalos | Internal Medicine | 8725 N Wickham Rd, Suite 302, Melbourne, FL 32940-5997 | 2005-08-17 |
| Find all providers in MELBOURNE | ||||
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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.