FRED KUSUMOTO


Address: 4500 San Pablo Rd S, Jacksonville, FL 32224-1865
Phone: 9049532000

FRED KUSUMOTO (NPI# 1265429427) 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) 1265429427
Entity Type Individual
Full Name FRED KUSUMOTO
Credential MD
Practice Address 4500 San Pablo Rd S
Jacksonville
FL 32224-1865
Practice Telephone 9049532000
Enumeration Date 2005-10-03
Last Update Date 2020-08-31
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207RC0001X Internal Medicine
Specialization: Clinical Cardiac Electrophysiology
ME91015 FL Allopathic & Osteopathic Physicians

Office Location

Street Address 4500 SAN PABLO RD S
City JACKSONVILLE
State FL
Zip Code 32224-1865

Providers in the same location

NPI Name Taxonomy Address Enumeration
1891799136 Richard Clarke Agnew Thoracic Surgery (Cardiothoracic Vascular Surgery) 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2005-06-01
1427657964 Brianna Iannarelli Nurse Anesthetist, Certified Registered 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-10-24
1538768981 Heather Anne Dahlen Nurse Practitioner 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-10-17
1578161717 Szilvia Fortner Nurse Practitioner 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-10-10
1265049464 Carolyn Gonzalez Nurse Practitioner 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-09-30
1467065748 Ifeloluwa A Olutola Family Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-08-26
1366055568 Krina Dipak Vyas Pharmacist 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-08-26
1356954911 Haleigh Diane Shelton Pharmacist 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-08-24
1215548805 Victoria Zeilinger Reams Pharmacist 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-08-16
1558971382 Rachel Marie Hannon Nurse Practitioner 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2020-08-06
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1356974372 Noelle Parker Specialist/Technologist 1 Unf Drivve, Jacksonville, FL 32224 2020-02-18
1124685102 Charcy Rene Stiller Specialist/Technologist 1 Unf Dr., Jacksonville, FL 32224 2019-05-24
1265097513 Mayo Clinic Jacksonville Ambulance 13970 Zumbro Dr, Jacksonville, FL 32224 2019-05-02
1639681471 Brigantti Anesthesia & Spine Care Clinic/Center 1361 13th Ave South Suite #210, Jacksonville, FL 32224 2017-11-02
1093240061 Beric Emilio Berlioz Anesthesiology 4500 San Pablo Rd S # J, Jacksonville, FL 32224 2017-04-26
1609240746 Matthew James Dailey Nurse Anesthetist, Certified Registered 2500 San Pablo Rd S, Jacksonville, FL 32224 2015-11-29
1003299603 Upscale Personal Care Home Assisted Living Facility 4375 Autumn River Road, Jacksonville, FL 32224 2015-07-01
1629459375 Bellanid Fonseca Social Worker 3694 Summerlin Ln E, Jacksonville, FL 32224 2015-06-17
1164840500 Nicholas Scotto Physical Therapist 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 2014-04-02
1497093454 Quicker Care Urgent Care Point of Service 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 2013-01-27
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Taxonomy Information

Taxonomy Code 207RC0001X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine
Specialization Clinical Cardiac Electrophysiology

Taxonomy Definition

A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1629511035 Ibrahim Heart Clinic Pllc Internal Medicine 13842 Harbor Creek Pl, Jacksonville, FL 32224-6895 2016-12-02
1992707327 Robert A Luke Internal Medicine 4205 Belfort Rd, Suite 2069, Jacksonville, FL 32216-1471 2005-08-15
1104829399 Jay R Patterson Internal Medicine 1801 Barrs St, Ste 500, Jacksonville, FL 32204-4746 2005-05-23
1851551121 University of Florida Jacksonville Physicians Inc Internal Medicine 655 W 8th St, Ufjp Cardiology, Jacksonville, FL 32209-6511 2008-06-11
1083898449 Aaditya Mahendra Vora Internal Medicine 820 Prudential Dr, Suite 112, Jacksonville, FL 32207-8210 2007-12-20
1174596324 Lakshminarayana Venkatachalam Internal Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2006-02-08
1710974977 Thomas Flipse Internal Medicine 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 2005-10-03
1932101334 Satish R Goel Internal Medicine 7011 A C Skinner Pkwy, Suite 160, Jacksonville, FL 32256-6954 2005-08-15
1437152600 James Timothy Walsh Internal Medicine 1824 King Street, Suite 300, Jacksonville, FL 32204-4736 2005-05-23

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1356957336 Charlotte Arrhythmia Center Pllc Internal Medicine 3400 Tamiami Trl Bldg 2, Port Charlotte, FL 33952-8102 2020-09-16
1396365623 Tallahassee Memorial Healthcare Inc Internal Medicine 2100 Centerville Rd, Tallahassee, FL 32308-4379 2020-04-16
1780150524 Winter Haven Hospital Inc Internal Medicine 200 Avenue F Ne Fl 2, Winter Haven, FL 33881-4131 2018-10-19
1154897130 Sujata S. Balulad, Md., Pa Internal Medicine 1095 Highway A1a Apt 2201, Satellite Beach, FL 32937 2018-10-17
1710385240 Heart Rhythm Center of South Florida Pa Internal Medicine 7000 Sw 97th Ave., Suite 102, Miami, FL 33173-1474 2014-12-16
1306262712 Ian Parker Internal Medicine 6720 Crews Wood Ln, Lakeland, FL 33813-3955 2014-03-10
1578987855 Integrated Care,llc Internal Medicine 603 North Flamingo Road, Suite 255, Pembroke Pines, FL 33028-1013 2014-02-07
1861768061 Zubin Agarwal Internal Medicine 1600 Sw Archer Rd # 5, Gainesville, FL 32610-1473 2012-04-02
1427340355 Asim S Ahmed Internal Medicine 7720 Us Highway 98 W Ste 110, Miramar Beach, FL 32550 2011-05-11
1407184377 Sunil Kumar Internal Medicine 311 West Oak Street, Department of Cardiology, Kissimmee, FL 34741-2265 2009-12-03
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Competitor

Search similar providers

City JACKSONVILLE
Zip Code 32224

Improve Information

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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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