ANUNPORN SRISAWAT (NPI# 1295925030) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295925030 |
| Entity Type | Individual |
| Full Name | ANUNPORN SRISAWAT |
| Credential | M.D. |
| Practice Address |
4554 S Clyde Morris Blvd Suite 2 Port Orange FL 32129-5403 |
| Mailing Address |
Po Box 290035 Port Orange FL 32129-0035 |
| Practice Telephone | 3863042990 |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2011-10-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ME 95967 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4554 S CLYDE MORRIS BLVD SUITE 2 |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129-5403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386940013 | Tui Family Medicine Pl | Clinic/Center | 4554 S Clyde Morris Blvd, Suite 2, Port Orange, FL 32129-5403 | 2011-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1679892996 | Pamela Kirby Pa | Clinic/Center | 4606 South Clyde Morris Boulevard, Suite 1j, Port Orange, FL 32129 | 2010-05-26 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134504855 | Metcare of Florida, Inc. | Family Medicine | 3641 Clyde Morris Blvd, Suite 100, Port Orange, FL 32129-2357 | 2015-07-23 |
| 1952637530 | Elizabeth M Daquila | Family Medicine | 851 Dunlawton Ave Ste 102, Port Orange, FL 32127-4234 | 2009-11-02 |
| 1417118100 | Daniel Gregory Gottlieb | Family Medicine | 790 Dunlawton Ave Ste E, Port Orange, FL 32127-4222 | 2008-06-24 |
| 1831263458 | Richard S Mohammed | Family Medicine | 6114 Pheasant Ridge Dr, Port Orange, FL 32128-6984 | 2006-11-17 |
| 1154409431 | Raul L Zimmerman | Family Medicine | 3800 Woodbriar Trl, Port Orange, FL 32129-9626 | 2006-11-02 |
| 1407964141 | David Billmeier | Family Medicine | 5111 S Ridgewood Ave Ste 301, Port Orange, FL 32127-5170 | 2006-08-25 |
| 1497766331 | Wagid Fahim Guirgis | Family Medicine | 3953 S Nova Rd, Port Orange, FL 32127-4910 | 2006-08-09 |
| 1467469700 | Bhadresh I Patel | Family Medicine | 802 Dunlawton Ave, Ste 101, Port Orange, FL 32127 | 2006-08-01 |
| 1043224538 | Michael Morgan Dietch IIi | Family Medicine | 3875 S Nova Rd, Port Orange, FL 32127-4950 | 2006-07-28 |
| 1235174095 | Atlantic Family Medicine, Pa | Family Medicine | 1185 Dunlawton Ave, Suite 104, Port Orange, FL 32127-2905 | 2006-06-17 |
| Find all providers in PORT ORANGE | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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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.