SCOTT M DELLORSO (NPI# 1255694667) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255694667 |
Entity Type | Individual |
Full Name | SCOTT M DELLORSO |
Credential | M.D. |
Practice Address |
841 Prudential Dr Fl 10 Jacksonville FL 32207-8329 |
Mailing Address |
Po Box 41113 Jacksonville FL 32203-1113 |
Practice Telephone | 9043985404 |
Practice Fax Number | 9043915545 |
Mailing Telephone | 9043764400 |
Mailing Fax Number | 9043915595 |
Enumeration Date | 2012-06-20 |
Last Update Date | 2019-08-19 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
ME128245 | FL | Allopathic & Osteopathic Physicians |
Y | 2084V0102X |
Psychiatry & Neurology Specialization: Vascular Neurology |
ME128245 | FL | Allopathic & Osteopathic Physicians |
Street Address |
841 PRUDENTIAL DR FL 10 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32207-8329 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215906649 | Baptist Behavioral Health, LLC | Counselor | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2006-03-17 |
1669015111 | Miguel A Franco | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-10-28 |
1477103539 | Adeline Leon | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2019-09-19 |
1023537602 | Janette Thames | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2017-09-14 |
1275931339 | Henry Benson | Psychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-12-05 |
1487072245 | Omar Jishi Moore | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-03-30 |
1780008425 | Daniel Howard Olsen | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2014-02-18 |
1083846414 | Karen Cooper Sandbach | Clinical Neuropsychologist | 841 Prudential Dr Fl 10, Jacksonville, FL 32207-8329 | 2009-08-18 |
1427205038 | Jason Shaun Day | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-08-26 |
1528229184 | Georgia Gianakakos | Psychiatry & Neurology | 841 Prudential Dr Fl 10, Credentialing Department, Jacksonville, FL 32207-8329 | 2008-06-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033768981 | North Florida Pediatrics, Pa | Pediatrics | 4501 Atlantic Boulevard, Jacksonville, FL 32207 | 2019-09-04 |
1578117024 | Pragna Mukesh Dholakia | Nurse Practitioner | 2624 Atlantic Blvd., Jacksonville, FL 32207 | 2019-08-01 |
1821653601 | The Adoption Authority, Inc. | Case Management | 4940 Emerson Street, Suite 103, Jacksonville, FL 32207 | 2019-05-07 |
1255896080 | Elizabeth Lynn Houghton | Social Worker | Sulzbacher Village, 904-720-2079, Jacksonville, FL 32207 | 2019-02-06 |
1902374630 | Guilherme Jose Agnoletto | Neurological Surgery | 800 Prudential Drive Weaver Tower 11th Floor, Jacksonville, FL 32207 | 2018-11-12 |
1073008504 | Pavilion Infusion Therapy Inc | Durable Medical Equipment & Medical Supplies | 1301 Palm Avenue, Suite 220, Jacksonville, FL 32207 | 2018-06-27 |
1346733185 | Dueseason1 | Registered Nurse | 4058 Saint Augustine Rd, Jacksonville, FL 32207 | 2018-06-06 |
1164911913 | Eric Lang Poovey | Nurse Practitioner | Baptist Heart Specialists, 836 Prudential Drive Suite 1700, Jacksonville, FL 32207 | 2018-05-08 |
1902311046 | Spring Park Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3851 Emerson St Ste 13, Jacksonville, FL 32207 | 2017-12-12 |
1295247948 | Emed Urgent and Primary Care Pa | Clinic/Center | 2570 Atlantic Boulevard, Jacksonville, FL 32207 | 2017-11-02 |
Find all providers in zip 32207 |
Taxonomy Code | 2084V0102X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Vascular Neurology |
Vascular Neurology is a subspecialty in the evaluation, prevention, treatment and recovery from vascular diseases of the nervous system. This subspecialty includes the diagnosis and treatment of vascular events of arterial or venous origin from a large number of causes that affect the brain or spinal cord such as ischemic stroke, intracranial hemorrhage, spinal cord ischemia and spinal cord hemorrhage. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376745935 | Madhu B Vijayappa | Psychiatry & Neurology | 8984 Sw 64th Ln, Gainesville, FL 32608-8562 | 2007-06-04 |
1194837708 | Sally B Zachariah | Psychiatry & Neurology | 10000 Bay Pines Blvd,neurology Section, Vamedical Center,bay Pines, Bay Pines, FL 33744 | 2006-08-31 |
1740258110 | Nils H. Mueller-kronast | Psychiatry & Neurology | 8756 Boynton Beach Blvd Ste 2300, Boynton Beach, FL 33472-4439 | 2006-03-10 |
1063405975 | Mary June Derbenwick | Psychiatry & Neurology | 350 N Clyde Morris Blvd, Daytona Beach, FL 32114-2733 | 2005-08-25 |
1215475025 | Miami Stroke, LLC | Psychiatry & Neurology | 11750 Sw 40th St, Miami, FL 33175-3530 | 2017-02-01 |
1972918431 | David Stone | Psychiatry & Neurology | 1700 S Tamiami Trl, Sarasota, FL 34239-3509 | 2014-06-24 |
1972897023 | North Broward Hospital District | Psychiatry & Neurology | 201 E Sample Rd, Suite 106, Pompano Beach, FL 33064-3502 | 2011-06-07 |
1124337290 | Maxim Vladimirovich Mokin | Psychiatry & Neurology | 2 Tampa General Cir, 3rd Floor, Tampa, FL 33606-3603 | 2010-10-06 |
1144547134 | Muhammad Zeeshan Memon | Psychiatry & Neurology | 1611 Nw 12th Ave, Miami, FL 33136 | 2010-04-29 |
1497966394 | Ridwan Lin | Psychiatry & Neurology | 201 E Sample Rd, Pompano Beach, FL 33064-3502 | 2007-05-24 |
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City | JACKSONVILLE |
Zip Code | 32207 |
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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.