CHARLES K WANICH (NPI# 1376642355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376642355 |
| Entity Type | Individual |
| Full Name | CHARLES K WANICH |
| Credential | MD |
| Practice Address |
245 S Courtenay Parkway Bldg B Merritt Island FL 32952 |
| Practice Telephone | 3214535326 |
| Practice Fax Number | 3214528507 |
| Mailing Telephone | 3214535326 |
| Mailing Fax Number | 3214528507 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-10-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
ME36933 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 039647800 | 05 | |
| RR MEDICARE | 110202974 | 01 | |
| AETNA | 2168973 | 01 |
| Street Address |
245 S COURTENAY PARKWAY BLDG B |
| City | MERRITT ISLAND |
| State | FL |
| Zip Code | 32952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003029786 | Brevard Nephrology Group Pa | Internal Medicine | 245 S Courtenay Parkway, Bldg B, Merritt Island, FL 32952 | 2007-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841761673 | Pushpa Daliya | Physical Medicine & Rehabilitation | 1200 S Courtenay Pkwy, Merritt Island, FL 32952 | 2018-12-05 |
| 1407335458 | Merritt Island Outpatient Surgery Center, LLC | Clinic/Center | 450 E Merritt Island Cswy Ste 400, Merritt Island, FL 32952 | 2018-08-10 |
| 1760903272 | Harold A Utt Jr. | Audiologist | 105 N. Banana River Drive, Merritt Island, FL 32952 | 2017-07-06 |
| 1942720982 | Cadiz Senior Care | Assisted Living Facility | 1970 Farrington Drive, Merritt Island, FL 32952 | 2017-06-21 |
| 1891230884 | Jessica Orcel | Behavioral Analyst | 1680 E. Central Avenue, Merritt Island, FL 32952 | 2016-12-29 |
| 1770039539 | Haley Haskins | Student in an Organized Health Care Education/Training Program | 1655 Yates Dr., Merritt Island, FL 32952 | 2016-08-31 |
| 1891150900 | Kristin Stevenson | Case Management | 262 Island Beach Blvd, Mirritt Island, FL 32952 | 2015-12-17 |
| 1568835080 | Brilliant Smiles Orthodontics | Health Maintenance Organization | 455 Magnolia Avenue, Merritt Island, FL 32952 | 2015-11-05 |
| 1184967184 | Roseann Judith Simone | Assisted Living Facility | 280 Bahama Dr, Angel Guardian, Cocoa Beach, FL 32952 | 2013-03-28 |
| 1942558861 | Daven H Patel | Dentist | 800 E. Merritt Island Causeway, Merritt Island, FL 32952 | 2012-08-27 |
| Find all providers in zip 32952 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1427157494 | Samir K Yassa | Internal Medicine | 245 S Curtenay Parkway, Bldg B, Merritt Island, FL 32952 | 2006-09-22 |
| 1306945993 | Hany I Girgis | Internal Medicine | 245 S Courtenay Pkwy, Merritt Island, FL 32952-4856 | 2006-09-21 |
| 1003029786 | Brevard Nephrology Group Pa | Internal Medicine | 245 S Courtenay Parkway, Bldg B, Merritt Island, FL 32952 | 2007-05-08 |
| 1811085749 | Ellery E Canlas | Internal Medicine | 245 S Courtenay Pkwy, Merritt Island, FL 32952-4831 | 2006-10-10 |
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|---|---|---|---|---|
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| 1972117109 | Mogilishetty Pllc | Internal Medicine | 10012 Gulf Center Dr Ste 5292, Fort Myers, FL 33913-8904 | 2020-09-04 |
| 1033732797 | Nephron Care & Dialysis LLC | Internal Medicine | Health Central Hospital, 10000 West Colonial Drive, Ocoee, FL 34761 | 2020-05-28 |
| 1245853746 | Ronald M. Goldin, M.d.,p.a. | Internal Medicine | 4215 Burns Rd Ste 240, Palm Beach Gardens, FL 33410-4625 | 2020-05-19 |
| 1447879739 | F Duncan Scott Md Pa | Internal Medicine | 4516 E Highway 20 # 108, Niceville, FL 32578-9755 | 2020-04-16 |
| 1245879055 | Atza Swicht Transportation Corp | Internal Medicine | 1309 Santa Rosa Dr Apt 202, Kissimmee, FL 34741-7572 | 2019-12-26 |
| 1427699859 | Nephro Care Solutions, LLC | Internal Medicine | 1401 Sw 107th Ave Ste 301m, Miami, FL 33174-2553 | 2019-10-07 |
| 1285282871 | Lighthouse Renal Group Pa | Internal Medicine | 951 Nw 13th St Ste 5b, Boca Raton, FL 33486-2337 | 2019-08-28 |
| 1427617265 | Sunstate Kidney & Hypertension LLC | Internal Medicine | 9907 Warm Stone St, Thonotosassa, FL 33592-3350 | 2019-06-06 |
| 1205490091 | Central Florida Nephrology Pllc | Internal Medicine | 7350 Futures Dr Ste 1, Orlando, FL 32819-9082 | 2019-04-26 |
| Find all providers with the same taxonomy | ||||
| City | MERRITT ISLAND |
| Zip Code | 32952 |
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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.