GOOD SHEPHERD MEDICAL CLINIC PA (NPI# 1316180409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316180409 |
| Entity Type | Organization |
| Organization Name | GOOD SHEPHERD MEDICAL CLINIC PA |
| Practice Address |
11373 Cortez Blvd Suite 209 Brooksville FL 34613-5414 |
| Practice Telephone | 3525964027 |
| Practice Fax Number | 3525979727 |
| Mailing Telephone | 3525964027 |
| Mailing Fax Number | 3525979727 |
| Enumeration Date | 2009-04-20 |
| Last Update Date | 2009-04-20 |
| Authorized Official Name | DR. ROGER B LEE (PRESIDENT) |
| Authorized Official Telephone | 3526865023 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | GOOD SHEPHERD MEDICAL CLINIC PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
ME0048810 | FL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326207481 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd Ste 107, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1336301829 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 112, Spring Hill, FL 34606-1107 | 2008-06-26 |
| 1417116575 | Good Shepherd Medical Clinic Pa | Family Medicine | 11329 Cortez Blvd, Brooksville, FL 34613 | 2008-06-04 |
| 1154580215 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 108, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1699934752 | Good Shepherd Medical Clinic Pa | General Practice | 8425 Northcliffe Blvd, Suite 109, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1790944858 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 110, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1518126671 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 102, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1245499300 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 104, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1972762037 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 105, Spring Hill, FL 34606-1107 | 2008-06-04 |
| 1881853943 | Good Shepherd Medical Clinic Pa | Internal Medicine | 8425 Northcliffe Blvd, Suite 104, Spring Hill, FL 34606-1107 | 2008-06-04 |
| Street Address |
11373 CORTEZ BLVD SUITE 209 |
| City | BROOKSVILLE |
| State | FL |
| Zip Code | 34613-5414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356348064 | Steven Harding Moss | Orthopaedic Surgery | 11373 Cortez Blvd, Suite 301, Brooksville, FL 34613-5414 | 2005-07-07 |
| 1427547819 | Kevin Chao Hong | Student in an Organized Health Care Education/Training Program | 11373 Cortez Blvd, Brooksville, FL 34613-5414 | 2018-05-01 |
| 1255729638 | Pine Brook Pharmacy LLC | Pharmacy | 11373 Cortez Blvd, Suite 101, Brooksville, FL 34613-5414 | 2015-01-07 |
| 1265853402 | Ocala Oncology Center Pl | Urology | 11373 Cortez Blvd, Suite 405, Brooksville, FL 34613-5406 | 2013-12-13 |
| 1467873638 | Ocala Oncology Center Pl | Urology | 11373 Cortez Blvd, Suite 209, Brooksville, FL 34613-5414 | 2013-12-13 |
| 1639510829 | Ocala Oncology Center Pl | Internal Medicine | 11373 Cortez Blvd, Suite 200, Brooksville, FL 34613-5405 | 2013-07-16 |
| 1861735888 | Aaron Cleveland Denson | Internal Medicine | 11373 Cortez Blvd, Suite 200, Brooksville, FL 34613 | 2013-03-27 |
| 1326390501 | Access Health Care Physicians LLC | Clinic/Center | 11373 Cortez Blvd, 304, Brooksville, FL 34613-5414 | 2012-10-11 |
| 1790054872 | Florida Cancer Affiliates Pl | Radiology | 11373 Cortez Blvd, Suite 200, Brooksville, FL 34613-5414 | 2011-12-20 |
| 1215224126 | Oleg Gligich | Internal Medicine | 11373 Cortez Blvd, Suite 200, Brooksville, FL 34613 | 2011-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196836 | Izza Bazigh | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, Sr 50, Office of Graduate Medic, Brooksville, FL 34613 | 2020-05-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1407405822 | Medical Risk Solutions | Family Medicine | 12080 Cortez Blvd, Brooksville, FL 34613 | 2019-09-09 |
| 1528529245 | Edward Joseph Waseleski Jr. | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-26 |
| 1366903213 | Paresh Rangani | Student in an Organized Health Care Education/Training Program | 11375 Cortez Blvd., State Road 50, Brooksville, FL 34613 | 2019-03-25 |
| 1225558034 | Whitney King | Student in an Organized Health Care Education/Training Program | 11375 Cortez Boulevard, State Road 50, Brooksville, FL 34613 | 2017-06-22 |
| 1922450022 | Visionworks, Inc | Eyewear Supplier (Equipment, not the service) | 13217 Cortez Rd, Brooksville, FL 34613 | 2016-07-13 |
| 1992157408 | Arushi Goel | Internal Medicine | 11375 Cortez Boulevard, Oak Hill Hospital, Brooksville, FL 34613 | 2016-07-08 |
| 1366823122 | Monicka Stella Felix | Internal Medicine | 11375 Cortez Boulevard, Sr 50, Oak Hill Hospital, Gme Attn: Melissa Tammaro, Brooksville, FL 34613 | 2015-06-17 |
| 1790171700 | April Greer | Hearing Instrument Specialist | 13013 Cortez Blvd., Brooksville, FL 34613 | 2015-04-07 |
| Find all providers in zip 34613 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346276631 | Lingappa Amarchand | Internal Medicine | 750 Desoto Ave, Brooksville, FL 34601-2814 | 2006-06-25 |
| 1114925989 | Scott Frank Lee | Internal Medicine | 11373 Cortez Blvd Ste 301, Brooksville, FL 34613-5411 | 2005-07-14 |
| 1528589025 | Mitchell S Halperin M.d., P.a. | Internal Medicine | 11375 Cortez Blvd, Brooksville, FL 34613-5409 | 2017-07-05 |
| 1144592007 | Abdelnasser Elmansoury Md Pa | Internal Medicine | 17222 Hospital Blvd, Suite 238, Brooksville, FL 34601-8925 | 2012-02-07 |
| 1861660029 | V P Jeyabarath Md Pa | Internal Medicine | 17222 Hospital Blvd, Ste 116, Brooksville, FL 34601-8925 | 2008-02-11 |
| 1124215249 | Mowaffak Atfeh | Internal Medicine | 11373 Cortez Blvd, Suite 307, Brooksville, FL 34613-5414 | 2007-10-02 |
| 1225224686 | A M Eldin Md Pa | Internal Medicine | 12082 Cortez Blvd, Brooksville, FL 34613-7371 | 2007-09-19 |
| 1467586065 | Mowaffak Atfeh Md Pa | Internal Medicine | 11373 Cortez Blvd, Suite 307, Brooksville, FL 34613 | 2007-03-15 |
| 1538262332 | Oakhill Heart Associates | Internal Medicine | 11373 Cortez Blvd, Ste 200, Brooksville, FL 34613-5414 | 2006-09-07 |
| 1881627875 | Muttathil P Ravindra Nathan Md Pa | Internal Medicine | 14540 Cortez Blvd, Suite 119, Brooksville, FL 34613-6056 | 2006-07-10 |
| Find all providers in BROOKSVILLE | ||||
| City | BROOKSVILLE |
| Zip Code | 34613 |
Please comment or provide details below to improve the information on GOOD SHEPHERD MEDICAL CLINIC PA.
| 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.