SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. (NPI# 1295156941) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295156941 |
Entity Type | Organization |
Organization Name | SOUTHEAST ORTHOPEDIC SPECIALISTS, INC. |
Practice Address |
10475 Centurion Pkwy N Ste 220 Jacksonville FL 32256-5004 |
Mailing Address |
6500 Bowden Rd Suite 103 Jacksonville FL 32216-8070 |
Practice Telephone | 9046340640 |
Practice Fax Number | 9046746155 |
Mailing Telephone | 9046340640 |
Mailing Fax Number | 9046746155 |
Enumeration Date | 2013-12-26 |
Last Update Date | 2018-09-27 |
Authorized Official Name | JANET N JAGUNIC (CREDENTIALING MANAGER) |
Authorized Official Telephone | 9046340640 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 174400000X | Specialist | Other Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | BCBS | 74895 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922615830 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2020-09-24 |
1881179638 | Southeast Orthopedic Specialists, Inc. | Specialist | 4565 Us Highway 17 Ste 200, Fleming Island, FL 32003-4823 | 2018-09-27 |
1477058709 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2001 County Road 210 W Ste 200, Saint Johns, FL 32259-2063 | 2018-03-28 |
1114383023 | Southeast Orthopedic Specialists, Inc. | Specialist | 15255 Max Leggett Pkwy, 5th Floor, Jacksonville, FL 32218-7273 | 2016-01-07 |
1730500489 | Southeast Orthopedic Specialists, Inc. | Specialist | 2300 Park Ave, Suite 203, Orange Park, FL 32073-5571 | 2013-12-26 |
1730500497 | Southeast Orthopedic Specialists, Inc. | Specialist | 1658 St Vincents Way Ste 100, Middleburg, FL 32068-8447 | 2013-12-26 |
1629025820 | Southeast Orthopedic Specialists, Inc. | Orthopaedic Surgery | 2627 Riverside Ave, 3rd Floor, Jacksonville, FL 32204-4712 | 2006-05-31 |
Street Address |
10475 CENTURION PKWY N STE 220 |
City | JACKSONVILLE |
State | FL |
Zip Code | 32256-5004 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114571312 | Tashia Marie Santiago | Registered Nurse | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2019-07-26 |
1053825372 | Victoria Christine Morrow | Physical Therapy Assistant | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2017-11-22 |
1073030599 | Angelia M. Johnson | Physical Therapy Assistant | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2017-08-25 |
1144757790 | Hannah R. Coxwell | Physical Therapy Assistant | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2017-05-15 |
1205363850 | Paereak Meng | Physical Therapy Assistant | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2017-05-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841890464 | Alice Sanchez | Dietitian, Registered | 7643 Gate Parkway, Suite 104-1128, Jacksonville, FL 32256 | 2020-11-01 |
1093327702 | Oaktree Dental LLC | Clinic/Center | 14595 Philips Highway, Jacksonville, FL 32256 | 2020-08-24 |
1538787866 | Tywanna Council | Massage Therapist | 4720 Salisbury Road #102, Jacksonville, FL 32256 | 2020-07-13 |
1275155368 | Christy Orellana | Social Worker | 5011 Gate Parkway Bldg 100 Suite 100, Jacksonville, FL 32256 | 2020-05-11 |
1376175117 | Diane Stover | Case Manager/Care Coordinator | 7001 A. C. Skinner Parkway, Jacksonville, FL 32256 | 2020-02-10 |
1982235859 | Sandra Josefina Baez Nunez | Nurse Practitioner | 10739 Deerwood Park Blvd, Suite 200, Jacksonville, FL 32256 | 2020-01-30 |
1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
1003472499 | Dade Medical, Inc. | Durable Medical Equipment & Medical Supplies | 9143 Philips Highway Suite 270, Jacksonville, FL 32256 | 2019-05-13 |
1003479726 | Nichole Bashara | Behavior Technician | 8383 Baymeadows Rd, Jacksonville, FL 32256 | 2019-04-18 |
Find all providers in zip 32256 |
Taxonomy Code | 174400000X |
Grouping | Other Service Providers |
Classification | Specialist |
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
1437620986 | Nicole Azaan | Specialist | 2301 Indian Dr Apt 29c, Jacksonville, NC 28546-5258 | 2018-12-10 |
1598251910 | Allionz LLC | Specialist | 2386 Dunn Ave Ste 109, Jacksonville, FL 32218-4751 | 2018-07-09 |
1093236531 | Leah F Friedman | Specialist | 1650 Prudential Dr Ste 102, Jacksonville, FL 32207-8148 | 2017-07-06 |
1609301993 | Oakleaf Injury and Pain Center LLC | Specialist | 9526 Argyle Forest Blvd, B-6, Jacksonville, FL 32222-2825 | 2017-04-25 |
1982070140 | Riverside Spine & Pain Physicians, LLC | Specialist | 13133 Professional Dr, Suite 200, Jacksonville, FL 32225-7122 | 2015-08-11 |
1235525239 | Elizabeth Wehr | Specialist | 319 1st Ave N Apt 1a, Jacksonville, FL 32250-5500 | 2015-04-07 |
1053705236 | Orthowilmington, Pa | Specialist | 3382 Henderson Dr, Jacksonville, NC 28546-5230 | 2015-03-25 |
1750627725 | Scott A Entsminger | Specialist | 13947 Beach Blvd Ste 109, Jacksonville, FL 32224-1201 | 2012-12-20 |
Find all providers in JACKSONVILLE |
City | JACKSONVILLE |
Zip Code | 32256 |
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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.