EDWIDGE L RAOUL (NPI# 1417089160) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417089160 |
| Entity Type | Individual |
| Full Name | EDWIDGE L RAOUL |
| Credential | M.D. |
| Practice Address |
3512 S Atlantic Ave Daytona Beach Shores FL 32118-7639 |
| Mailing Address |
1885 Carrin St Deltona FL 32738-7714 |
| Practice Telephone | 3867679544 |
| Practice Fax Number | 3867560501 |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
ME79247 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
3512 S ATLANTIC AVE |
| City | DAYTONA BEACH SHORES |
| State | FL |
| Zip Code | 32118-7639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700877388 | Gerald R Woodard | Family Medicine | 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118-7639 | 2005-11-02 |
| 1336546506 | Bettina Fulford | Family Medicine | 3512 S Atlantic Ave, Shores Medical Center, Daytona Beach Shores, FL 32118 | 2014-12-03 |
| 1497166417 | Gerald R Woodard Do Pa | Non-Pharmacy Dispensing Site | 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118-7639 | 2014-05-13 |
| 1518391523 | Smc Rehab Services, LLC | Family Medicine | 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118-7639 | 2013-08-27 |
| 1114111440 | Gerald R Woodard Do Pa | Family Medicine | 3512 S Atlantic Ave, Daytona Beach Shores, FL 32118-7639 | 2007-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407476633 | Adel Demetrious | Dentist | 2727 North Atlantic, Ave, Suite 121, Dayton Beach, FL 32118 | 2020-04-17 |
| 1518433804 | Tara James | Nurse Practitioner | 224 Seabreeze Blvd, Daytona Beach, FL 32118 | 2018-10-15 |
| 1760835706 | Barbara Fuller | Early Intervention Provider Agency | 125 Cheshire Rd, Daytona Beach, FL 32118 | 2016-07-14 |
| 1821486457 | Emily Catherine Lounsbury | Nurse Practitioner | 3512 South Atlantic Avenue, Daytona Beach Shores, FL 32118 | 2015-01-06 |
| 1215334370 | Shores Medical Center | Nurse Practitioner | 3512 S Atlantic Blvd, Daytona Beach Shores, FL 32118 | 2014-12-04 |
| 1619305075 | Kimberly Barr Beck-frate | Counselor | 444 Seabreeze Blvd., Integrative Crisis Management, Suite 725, Daytona Beach, FL 32118 | 2013-10-23 |
| 1104190792 | Demetrius Marketing LLC | Dentist | 2570 South Atlantic Ave., Marina Dental Center, Daytona Beach Shores, FL 32118 | 2012-02-29 |
| 1255603189 | A1a Medical | General Practice | 1401 North Atlantic Avenue, Daytona Beach, FL 32118 | 2012-02-08 |
| 1184755654 | David Gaughan | Physical Medicine & Rehabilitation | 3512 S Atlantic Av., Daytona Beach Shores, FL 32118 | 2007-03-08 |
| 1952497612 | Ability Health Services, Inc | Durable Medical Equipment & Medical Supplies | 614 N. Penisula Dr, Daytona Beach, FL 32118 | 2006-10-04 |
| Find all providers in zip 32118 | ||||
| Taxonomy Code | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184755654 | David Gaughan | Physical Medicine & Rehabilitation | 3512 S Atlantic Av., Daytona Beach Shores, FL 32118 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477161214 | Radius Medical Center LLC | Physical Medicine & Rehabilitation | 2425 E Commercial Blvd Ste 203, Fort Lauderdale, FL 33308-4062 | 2020-07-17 |
| 1912460874 | Lags Spine and Sportscare Medical Centers, Inc. | Physical Medicine & Rehabilitation | 5701 21st Ave W Ste 3, Bradenton, FL 34209-5605 | 2019-04-08 |
| 1508320342 | Grigory Pogrebinsky Md Pa | Physical Medicine & Rehabilitation | 12450 Tamiami Trl S Unit E, North Port, FL 34287-1473 | 2019-01-25 |
| 1235611815 | Peter Danger Molina | Physical Medicine & Rehabilitation | 1190 Nw 95th St Ste 200, Miami, FL 33150-2064 | 2018-08-30 |
| 1497246540 | Restore Medical Partners Pllc | Physical Medicine & Rehabilitation | 333 Tamiami Trl S Ste 101, Venice, FL 34285-2425 | 2018-05-24 |
| 1568952240 | South Florida Physical Medicine and Rehabilitation Center LLC | Physical Medicine & Rehabilitation | 1200 S Main St Ste 200, Belle Glade, FL 33430-7808 | 2018-05-17 |
| 1235641655 | Boca Pain Care, Inc | Physical Medicine & Rehabilitation | 851 Meadows Rd Ste 213, Boca Raton, FL 33486-2348 | 2017-10-25 |
| 1558870477 | Pain Control Solutions II LLC | Physical Medicine & Rehabilitation | 8323 Nw 12th Street, Suite 115, Miami, FL 33126 | 2017-09-22 |
| 1245759851 | Chelsea Hakeem | Physical Medicine & Rehabilitation | 8936 77th Terrace East, Suit 101, Lakewood Ranch, FL 34202 | 2017-09-14 |
| 1508384165 | Destiny Therapy Center Inc | Physical Medicine & Rehabilitation | 7480 Fairway Dr., Suite 101, Miami Lakes, FL 33014 | 2017-09-05 |
| Find all providers with the same taxonomy | ||||
| City | DAYTONA BEACH SHORES |
| Zip Code | 32118 |
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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.