POONAM MISHRA (NPI# 1306836952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1306836952 |
Entity Type | Individual |
Full Name | POONAM MISHRA |
Credential | D.O. |
Practice Address |
401 N Wickham Rd Suite H Melbourne FL 32935-8659 |
Practice Telephone | 3217575105 |
Practice Fax Number | 3217575104 |
Mailing Telephone | 3217575105 |
Mailing Fax Number | 3217575104 |
Enumeration Date | 2005-10-25 |
Last Update Date | 2015-02-06 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
593360315 | FL | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
FL | BCBS MAB GROUP | 40462 | 01 |
FL | BCBS PROVIDER ID | 57174 | 01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194099333 | Poonam Mishra | Internal Medicine | 10 Center Dr., Nih/niddk, Bethesda, MD 20892-0001 | 2012-03-06 |
1437312337 | Poonam Mishra | Hospitalist | 3601 W 13 Mile Rd, Royal Oak, MI 48073-6712 | 2008-07-10 |
Street Address |
401 N WICKHAM RD SUITE H |
City | MELBOURNE |
State | FL |
Zip Code | 32935-8659 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669750873 | Brevard Hma Hme, LLC | Durable Medical Equipment & Medical Supplies | 401 N Wickham Rd, Suite K, Melbourne, FL 32935-8659 | 2011-07-22 |
1295051845 | Ashwini Healthcare LLC | Pharmacy | 401 N Wickham Rd, Suite W and X, Melbourne, FL 32935-8659 | 2010-04-07 |
1134231079 | The Affordable Apothecary Inc | Pharmacy | 401 N Wickham Rd, Ste E, Melbourne, FL 32935-8659 | 2006-08-31 |
1477562403 | Medical Associates of Brevard LLC | Clinic/Center | 401 N Wickham Rd, Suite H, Melbourne, FL 32935-8659 | 2006-08-07 |
1366463226 | Jay E. Olsson, D.o., P.a. | Physical Medicine & Rehabilitation | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-07-23 |
1144264904 | Jay Edward Olsson | Physical Medicine & Rehabilitation | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-06-15 |
1841234721 | Christopher Stanley Cole | Physician Assistant | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2006-06-15 |
1265415103 | Michelle Jane Madan | Nurse Practitioner | 401 N Wickham Rd, Suite S, Melbourne, FL 32935-8659 | 2005-11-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407412018 | Aleecia Estime | Nurse Practitioner | 401 N Wickham Rd Ste S, Melbourne, FL 32935 | 2019-05-20 |
1669948261 | Lisa Marie Sarkees | Social Worker | 1503 Spring Drive, Melbourne, FL 32935 | 2018-10-22 |
1407355399 | Eugene Slaughter | Case Manager/Care Coordinator | 1600 W Eau Gallie Blvd. Suite 201 F, Melbourne, FL 32935 | 2018-02-06 |
1588173173 | Gregory M Mcdermand | Respiratory Therapist, Certified | 2745 Revolution St, Unit 101, Melbourne, FL 32935 | 2017-09-26 |
1386173649 | M Shami | Nurse Practitioner | 401 N Wickham Rd. Suite S, Melbourne, FL 32935 | 2017-06-08 |
1588102297 | Chiro Choice A Limited Liability Company | Clinic/Center | 1310 W Eau Galle Blvd Ste A, Melbourne, FL 32935 | 2017-02-02 |
1124574835 | A Loving Touch Private Home Care | Home Health | 1595 Palmwood Drive, Melbourne, FL 32935 | 2016-09-01 |
1538616099 | Pedro Triana Villamil | Specialist/Technologist, Other | 1600 Sarno Rd. Suite 15, Melbourne, FL 32935 | 2016-09-01 |
1528424132 | Lisa Forsythe | Acupuncturist | 1250 W. Eau Gallie Blvd., Suite H, Melbourne, FL 32935 | 2016-01-12 |
1528432028 | Harbor City Pharmacy Inc | Pharmacy | 503 Harbor City Blvd., Melbourne, FL 32935 | 2015-11-20 |
Find all providers in zip 32935 |
Taxonomy Code | 207QA0505X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Specialization | Adult Medicine |
Definition to come. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588705768 | First Care Family Physicians | Family Medicine | 1051 Eber Blvd, Ste 101, Melbourne, FL 32904-8768 | 2007-02-09 |
1255780615 | Stephen M Giorgianni Do Pllc | Family Medicine | 1341 Bedford Dr Ste B, Melbourne, FL 32940-1986 | 2016-06-07 |
1962544718 | Wuesthoff Health Services Inc | Family Medicine | 8060 Spyglass Hill Rd, Melbourne, FL 32940-7983 | 2007-02-12 |
1659399129 | John M Gayden Jr. | Family Medicine | 1251 Hickory St, Melbourne, FL 32901-3221 | 2006-07-17 |
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1831704345 | Vasundhara Kuchibhotla | Family Medicine | 1630 Sw 75th Ter, Gainesville, FL 32607-6604 | 2020-09-11 |
1356952170 | Discreet Health Solutions, LLC | Family Medicine | 7124 Pelican Island Dr, Tampa, FL 33634-7463 | 2020-08-14 |
1033728019 | Nana Aisha Garba | Family Medicine | 11200 Sw 8th St Ahc2 Rm 589b, Miami, FL 33199-0001 | 2020-07-27 |
1043838451 | Lisa M Parker | Family Medicine | 7955 Bay St Ste 2, Sebastian, FL 32958-3282 | 2020-07-13 |
1699390336 | Rosenie B Jasmin | Family Medicine | Dove Medical Centers, LLC, 2901 West Oakland Park Blvd Ste A4-5, Oakland Park, FL 33311 | 2020-06-09 |
1588287239 | Sarai L Gonzalez | Family Medicine | 16182 Nw 21st St, Pembroke Pines, FL 33028-1255 | 2020-05-28 |
1184247033 | Wellness Solutions 2020 LLC | Family Medicine | 2300 N Commerce Pkwy Ste 321, Weston, FL 33326-3257 | 2020-05-27 |
1780207910 | Homeville Medical Care | Family Medicine | 11040 Nw 18th Ct, Plantation, FL 33322-3407 | 2020-05-21 |
1942829536 | Health Medical Ultra Limited Liability Company | Family Medicine | 1760 Havendale Blvd Nw, Winter Haven, FL 33881-1224 | 2020-04-13 |
Find all providers with the same taxonomy |
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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.