DR. LYLE E WADSWORTH (NPI# 1356347561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356347561 |
| Entity Type | Individual |
| Full Name | DR. LYLE E WADSWORTH |
| Credential | MD |
| Practice Address |
890 N Boundary Ave Ste 102 Deland FL 32720-3173 |
| Practice Telephone | 3867400224 |
| Practice Fax Number | 3867409711 |
| Mailing Telephone | 3867400224 |
| Mailing Fax Number | 3867409711 |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2008-03-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
ME30902 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BC/BS | 64391 | 01 |
| FL | AETNA | 5490138 | 01 |
| FL | UNITEDHEALTHCARE | 000050266105 | 01 |
| FL | CIGNA | 2198298007 | 01 |
| Street Address |
890 N BOUNDARY AVE STE 102 |
| City | DELAND |
| State | FL |
| Zip Code | 32720-3173 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205282845 | Jordan Johnston | Physical Therapist | 890 N Boundary Ave, Deland, FL 32720-3173 | 2016-05-13 |
| 1992113096 | Kristina Carroll | Physical Therapist | 890 N Boundary Ave, Deland, FL 32720-3173 | 2014-08-01 |
| 1275852675 | Norleen R Mccoy | Physical Therapist | 890 N Boundary Ave, Ste 200, Deland, FL 32720-3173 | 2010-05-25 |
| 1275768046 | Lalita D Tivey | Physical Therapist | 890 N Boundary Ave, Deland, FL 32720-3173 | 2009-05-22 |
| 1083762413 | Trittschuh Physical Therapy Inc | Physical Therapist | 890 N Boundary Ave, Suite 200, Deland, FL 32720 | 2007-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171532 | Kimberlee C Del Campo | Nurse Practitioner | 1590 S, State Highway 15a, Deland, FL 32720 | 2020-10-13 |
| 1699304840 | Grace Haven LLC | In Home Supportive Care | 805 S Stone St, Deland, FL 32720 | 2020-04-08 |
| 1609407766 | Michelle Rene' Tutt | Nurse Practitioner | 1590 South State Hwy 15a, Deland, FL 32720 | 2020-01-28 |
| 1902448715 | Volusia Medical Center LLC | Family Medicine | 850 N. Stone Street, Deland, FL 32720 | 2019-10-14 |
| 1548748957 | Christopher Lee Paik | Internal Medicine | 107 N Stone St, St A, Deland, FL 32720 | 2018-07-30 |
| 1164961041 | Melissa Sorensen | Counselor | 970 N Spring Ave, 523, Deland, FL 32720 | 2017-02-13 |
| 1669910329 | Stefanie Briann Yockey | Counselor | 804 N. Woodland Blvd., Deland, FL 32720 | 2017-02-02 |
| 1144648809 | Steven Shinn | Internal Medicine | 1590 S Sr 15a Ste 100, Deland, FL 32720 | 2014-03-31 |
| 1164843710 | Malgorzata Anna Szelwach | Occupational Therapist | 1590 State Rt 15a Suite B, Deland, FL 32720 | 2013-12-29 |
| 1730510926 | Adriana Marquez | Community/Behavioral Health | 33218 Tomahawk Trail, Deland, FL 32720 | 2013-12-12 |
| Find all providers in zip 32720 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528549490 | Ultra Health Providers of Florida | Internal Medicine | 105 Asterbrooke Dr, Deland, FL 32724 | 2018-08-28 |
| 1205018207 | Lyle E Wadsworth Md Pa | Internal Medicine | 890 N Boundary Ave Ste 102, Deland, FL 32720-3173 | 2007-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669087722 | Norma Leticia Goodrich | Internal Medicine | 19265 Nw 252nd St, Okeechobee, FL 34972-6966 | 2020-09-14 |
| 1356811897 | Lake Behavioral Health Management | Internal Medicine | 225 W Canton Ave Ste 600, Winter Park, FL 32789-3181 | 2018-11-27 |
| 1710464946 | Baptist Agewell Physicians Inc | Internal Medicine | 1350 13th Ave S Ste 118-a, Jacksonville Beach, FL 32250-3203 | 2018-07-20 |
| 1659891018 | Pocketdoc Physicians Pa | Internal Medicine | 333 Se 2nd Ave Ste 2000, Miami, FL 33131-2185 | 2017-06-26 |
| 1003349549 | On Call Wound Care LLC | Internal Medicine | 12798 Forest Hill Blvd Ste 205b, Wellington, FL 33414-4768 | 2017-04-11 |
| 1154781284 | Verimed Health Group Land O' Lakes, LLC | Internal Medicine | 2638 Narnia Way, Ste 101, Land O Lakes, FL 34638-7231 | 2016-03-02 |
| 1083082895 | Edith Maria Ortega | Internal Medicine | 528 Oceanfront, Neptune Beach, FL 32266 | 2015-09-10 |
| 1881083020 | Arnold Jay Simon, M.d. | Internal Medicine | 3175 S Congress Ave Ste 305, Palm Springs, FL 33461-2562 | 2015-01-12 |
| 1912300575 | Geriatrics and Hospitalists Associates | Internal Medicine | 3255 Cypress Legends Cir Apt 433, Fort Myers, FL 33905-5516 | 2014-09-26 |
| 1396151809 | Susana Gonzalez, M.d., P.a. | Internal Medicine | 1225 Alton Road, Miami Beach, FL 33139 | 2014-07-03 |
| 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.