ATLANTIC UROLOGICAL ASSOCIATES P A (NPI# 1407812092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407812092 |
| Entity Type | Organization |
| Organization Name | ATLANTIC UROLOGICAL ASSOCIATES P A |
| Practice Address |
545 Health Blvd Daytona Beach FL 32114-1493 |
| Practice Telephone | 3862398500 |
| Practice Fax Number | 3862398530 |
| Mailing Telephone | 3862398500 |
| Mailing Fax Number | 3862398530 |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2012-12-13 |
| Authorized Official Name | JERRI CREGGAR (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 3862398500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 037142400 | 05 | |
| UNITED HEALTHCARE | 1900147 | 01 | |
| FL | BLUE SHIELD | 99107 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174792642 | Atlantic Urological Associates P A | Urology | 21 Hospital Dr, Suite 140, Palm Coast, FL 32164-2380 | 2008-02-28 |
| 1659586840 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-11 |
| 1932321429 | Atlantic Urological Associates P A | Urology | 633 Dunlawton Ave, Suite 2, Port Orange, FL 32127 | 2007-05-03 |
| 1114148574 | Atlantic Urological Associates P A | Urology | 1620 Mason Ave, Suite E, Daytona Beach, FL 32117-7802 | 2007-05-02 |
| 1548481054 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-01 |
| 1881815561 | Atlantic Urological Associates P A | Urology | 506 Palmetto St, New Smyrna Beach, FL 32168-7325 | 2007-05-01 |
| 1285855890 | Atlantic Urological Associates P A | Urology | 1061 Medical Center Dr, Suite 300, Orange City, FL 32763-8200 | 2007-05-01 |
| 1053532572 | Atlantic Urological Associates P A | Urology | 2460 Old Moultrie Rd, Suite 5, St Augustine, FL 32086-4197 | 2007-05-01 |
| 1134340615 | Atlantic Urological Associates P A | Urology | 19 Old Kings Rd N, Suite C101, Palm Coast, FL 32137-8260 | 2007-05-01 |
| Street Address |
545 HEALTH BLVD |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32114-1493 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407359854 | Quynh-dao Tonnu | Physician Assistant | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2018-03-12 |
| 1881110690 | Hanna-marie Brockway | Nurse Practitioner | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2017-08-15 |
| 1659726248 | Advanced Urology Institute LLC | Non-Pharmacy Dispensing Site | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2016-05-02 |
| 1366883209 | Katherine Elizabeth Gardner | Nurse Practitioner | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2013-07-08 |
| 1598054751 | Samuel M. Lawindy | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2011-03-28 |
| 1790949873 | Evan Fynes | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2008-07-17 |
| 1184807166 | Mikhail Lezhak | Physician Assistant | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-12-12 |
| 1659586840 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-11 |
| 1548481054 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-01 |
| 1316978737 | Tony L Cantwell | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376161380 | Evolution Health & Performance LLC | Physician Assistant | 244 S. Palmetto Ave, Daytona Beach, FL 32114 | 2020-07-07 |
| 1407480189 | Kierra Imani Kinsey | Behavior Technician | 1128-a Beville Rd, Daytona Beach, FL 32114 | 2020-03-02 |
| 1043776057 | Outreach Community Care Network Inc | Pharmacy | 240 N. Frederick Avenue, Daytona Beach, FL 32114 | 2019-02-14 |
| 1033681861 | Katherine Proppe | Specialist/Technologist | 1 Aerospace Blvd, Daytona Beach, FL 32114 | 2018-12-18 |
| 1841765047 | Anna L Smith | Nurse Practitioner | 339 Bill France Blvd Ste C, Daytona Beach, FL 32114 | 2018-10-04 |
| 1154806933 | Steve Anthony Lee | Family Medicine | 731 N. Clyde Morris Blvd, Daytona Beach, FL 32114 | 2018-09-27 |
| 1285116491 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1348 W International Speedway Blvd Ste 2, Daytona Beach, FL 32114 | 2018-09-04 |
| 1770085656 | Merina Lee | Occupational Therapist | 1159 Australia Ave., Daytona Beach, FL 32114 | 2018-03-06 |
| 1346752755 | Hand & Upper Extremity Surgery of Daytona Beach, LLC | Non-Pharmacy Dispensing Site | 1241 Ridgewood Ave, Daytona Beach, FL 32114 | 2017-10-26 |
| 1104347053 | Harry Herman Blanke IIi | Family Medicine | 201 N Clyde Morris Blvd, Suite 200, Halifax Health Family Medicine Residency Program, Daytona Beach, FL 32114 | 2017-06-30 |
| Find all providers in zip 32114 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932148509 | John Elbert Greene | Urology | 311 N Clyde Morris Blvd Ste 480, Daytona Beach, FL 32114-2766 | 2006-06-06 |
| 1063484848 | Sean Tirney | Urology | 1925 S Atlantic Ave, Suite #609, Daytona Beach, FL 32118-5026 | 2006-02-06 |
| 1598015398 | Dale R Traficante Md Pa | Urology | 1890 Lpga Blvd, Suite 220, Daytona Beach, FL 32117-7138 | 2012-09-19 |
| 1598054751 | Samuel M. Lawindy | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2011-03-28 |
| 1790949873 | Evan Fynes | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2008-07-17 |
| 1043416506 | Shawn Wayne Thomas | Urology | 311 N Clyde Morris Blvd Ste 360, Daytona Beach, FL 32114-2757 | 2007-06-22 |
| 1659586840 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-11 |
| 1114148574 | Atlantic Urological Associates P A | Urology | 1620 Mason Ave, Suite E, Daytona Beach, FL 32117-7802 | 2007-05-02 |
| 1548481054 | Atlantic Urological Associates P A | Urology | 545 Health Blvd, Daytona Beach, FL 32114-1493 | 2007-05-01 |
| 1306999123 | Charles E Womack | Urology | 303 N Clyde Morris Blvd, Daytona Beach, FL 32114-2709 | 2007-01-18 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32114 |
Please comment or provide details below to improve the information on ATLANTIC UROLOGICAL ASSOCIATES P A.
| 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.