COLIN D AGERTON (NPI# 1245540632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245540632 |
| Entity Type | Individual |
| Full Name | COLIN D AGERTON |
| Practice Address |
6117 Gunn Hwy Tampa FL 33625-4013 |
| Mailing Address |
13020 N Telecom Pkwy Temple Terrace FL 33637-0925 |
| Practice Telephone | 8139789700 |
| Practice Fax Number | 8135586187 |
| Mailing Telephone | 8139789700 |
| Mailing Fax Number | 8135586187 |
| Enumeration Date | 2010-10-19 |
| Last Update Date | 2015-06-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA9105738 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9105738 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 004380300 | 05 | |
| FL | STATE LICENSE | PA9105738 | 01 |
| FL | BCBS | Y09H3 | 01 |
| Street Address |
6117 GUNN HWY |
| City | TAMPA |
| State | FL |
| Zip Code | 33625-4013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285639021 | Heather L Lacross | Nurse Practitioner | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2005-06-17 |
| 1699286492 | Andrew Tharaldson | Physical Therapy Assistant | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2017-10-19 |
| 1982155362 | Musculoskeletal Institute Chartered | Clinic/Center | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2016-10-20 |
| 1447636006 | Mark Ramirez | Physical Therapy Assistant | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2015-08-06 |
| 1215321062 | Lynsey Marie Dawson | Specialist/Technologist | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2015-03-18 |
| 1992139273 | Musculoskeletal Institute Chartered | Physical Therapist | 6117 Gunn Hwy, Tampa, FL 33625 | 2013-08-22 |
| 1114241213 | Jeffrey A Westerfield | Family Medicine | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2010-03-17 |
| 1235367483 | Seung Jin Yi | Orthopaedic Surgery | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2009-06-26 |
| 1417108374 | Jason A Nydick | Orthopaedic Surgery | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2008-10-08 |
| 1275796765 | Timothy Charles Epting | Orthopaedic Surgery | 6117 Gunn Hwy, Tampa, FL 33625-4013 | 2008-07-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316222 | Kyle Raymond Schindler | Physical Therapist | 12891 Citrus Park Dr, Tampa, FL 33625 | 2020-02-03 |
| 1558923771 | Rose Alexis | Nurse Practitioner | 5357 Enrlich Road, Tampa, FL 33625 | 2019-07-08 |
| 1831655380 | Tampa Family Health Centers, Inc | Clinic/Center | 12085 W. Hillsborough Ave., Tampa, FL 33625 | 2019-02-20 |
| 1083067664 | Adventist Health System/sunbelt, Inc. | Clinic/Center | 6930 Gunn Hwy, Tampa, FL 33625 | 2016-07-19 |
| 1285012773 | Be Bellus Med Spa | Clinic/Center | 6914 W Linebaugh Ave, Suite 102, Tampa, FL 33625 | 2015-05-15 |
| 1649519877 | Brenda Lee Figueroa | Nurse Practitioner | 6702 West Linebaugh Ave., Tampa, FL 33625 | 2013-02-07 |
| 1639424930 | Sheriece Sadberry | Psychologist | 6922 W Linebaugh Ave Ste 101c, Tampa, FL 33625 | 2012-07-23 |
| 1619244191 | Mariana Velandia | Counselor | 12819 Pacifica Pl, Tampa, FL 33625 | 2011-11-28 |
| 1245507003 | Oleston Chiropractic, P.a. | Chiropractor | 6575 Gunn Hwy, Tampa, FL 33625 | 2011-11-22 |
| 1891074027 | Christine M Klocek | Behavioral Analyst | 6543 Gunn Highway, Tampa, FL 33625 | 2011-08-05 |
| Find all providers in zip 33625 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336762046 | Samantha Martin | Physician Assistant | 12950 Race Track Rd Ste 106, Tampa, FL 33626-1304 | 2020-05-28 |
| 1124648159 | Christian Otero | Physician Assistant | 311 W Palm Ave, Tampa, FL 33602-2029 | 2020-04-20 |
| 1487219036 | Vanessa Natasha White | Physician Assistant | 10205 W Hillsborough Ave Ste B, Tampa, FL 33615-3671 | 2019-05-08 |
| 1518520873 | Zachary Luke Ulshafer | Physician Assistant | 12901 Bruce B Downs Blvd # 05, Tampa, FL 33612-4742 | 2019-04-22 |
| 1548756893 | Christopher Jacob Bordelon | Physician Assistant | 2550 W Dr Martin Luther King Jr Blvd Ste B, Tampa, FL 33607-6302 | 2018-07-10 |
| 1871033340 | Amanda Lins Chissell | Physician Assistant | 13801 Bruce B Downs Blvd Ste 231, Tampa, FL 33613-3946 | 2017-03-03 |
| 1669839767 | Barbara N Vargas | Physician Assistant | 12500 N Dale Mabry Hwy Ste A, Tampa, FL 33618-2809 | 2016-01-20 |
| 1215305776 | Amber Lubas | Physician Assistant | 401 N Rome Ave, Apt: 4314, Tampa, FL 33606-0009 | 2015-09-14 |
| 1972988467 | Karla Michelle Mincone | Physician Assistant | 3040 W Cypress St # 103, Tampa, FL 33609-1615 | 2015-07-25 |
| 1326441767 | Brigett Brandjes | Physician Assistant | 2902 Usf Magnolia Drive, Tampa, FL 33612 | 2014-09-30 |
| Find all providers in TAMPA | ||||
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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.