KEVIN M BOERNER


Address: 410 Celebration Place, Suite 200, Celebration, FL 34747-5432
Phone: 4073034673

KEVIN M BOERNER (NPI# 1457346959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457346959
Entity Type Individual
Full Name KEVIN M BOERNER
Credential PAC
Practice Address 410 Celebration Place
Suite 200
Celebration
FL 34747-5432
Practice Telephone 4073034673
Practice Fax Number 4073980050
Mailing Telephone 4073034673
Mailing Fax Number 8558345435
Enumeration Date 2005-09-12
Last Update Date 2014-01-14
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AS0400X Physician Assistant
Specialization: Surgical Technologist
PA1628 FL Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
FL 290145500 05

Office Location

Street Address 410 CELEBRATION PLACE
SUITE 200
City CELEBRATION
State FL
Zip Code 34747-5432

Providers in the same location

NPI Name Taxonomy Address Enumeration
1457614414 Joshua Ross Britt Podiatrist 410 Celebration Place, Suite 106, Celebration, FL 34747 2012-06-24
1437450343 Michael Earl Taylor Physician Assistant 410 Celebration Place, Suite 106, Celebration, FL 34747 2010-11-09
1114258118 Raniel Marc Barcenas Nurse Practitioner 410 Celebration Place, Suite 200, Celebration, FL 34747-5432 2010-01-15
1760534994 Joseph E. Robison Orthopaedic Surgery 410 Celebration Place, Suite 106, Celebration, FL 34747 2007-01-17
1942309695 John Douglas Mcdonald Family Medicine 410 Celebration Place, Suite 106, Celebration, FL 34747 2006-09-21
1487663928 Robert V Coleman Internal Medicine 410 Celebration Place, Suite 306, Celebration, FL 34747-5436 2006-08-05
1255355442 James Sutlive Atkins Jr. Specialist 410 Celebration Place, Suite 100, Celebration, FL 34747-5432 2006-07-27
1144254210 Brad Michael Homan Orthopaedic Surgery 410 Celebration Place, Suite 106, Celebration, FL 34747 2006-07-11
1952336042 David Dennis Dore Orthopaedic Surgery 410 Celebration Place, Suite 106, Celebration, FL 34747 2006-07-11
1578596003 Faissal Zahrawi Orthopaedic Surgery 410 Celebration Place, Suite 106, Celebration, FL 34747 2006-07-08
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1861974073 Keiler Heberto Moreno Rivero, P.a. Internal Medicine 2954 Mallory Cir #200, Kissimmee, FL 34747 2018-09-04
1437644952 Tri-county Nursing and Rehabilitation Center Inc Skilled Nursing Facility 1290 Celebration Blvd, Kissimmee, FL 34747 2018-06-27
1669918579 Kyle Mcclurg Specialist/Technologist 700 S Victory Way, Kissimmee, FL 34747 2017-01-17
1194277913 Norma Ivelisse Arzola Counselor 7519 Pellham Way, Kissimmee, FL 34747 2016-10-27
1528416625 Guillermo Rivera Counselor 8401 Titkos Drive Apt 201, Kissimmee, FL 34747 2016-05-31
1659780625 Keiler Moreno Rivero Internal Medicine 2954 Mallory Cir, Suite 200, Kissimmee, FL 34747 2014-08-04
1538596309 Chad Black Md, LLC Family Medicine 610 Sycamore Street Suite 130, Celebration, FL 34747 2013-10-10
1598046344 Adventist Health System/sunbelt, Inc. Non-Pharmacy Dispensing Site 8201 W. Irlo Bronson Hwy, Kissimmee, FL 34747 2011-09-07
1447467170 Matthew W Johnston Orthopaedic Surgery 410 Celectration Place, Suite 106, Celebration, FL 34747 2007-05-16
1457563538 Eric Edwin Malek Specialist/Technologist 700 South Victory Way, Kissimmee, FL 34747 2007-05-03
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Taxonomy Information

Taxonomy Code 363AS0400X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Surgical Technologist

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720631567 Neley Morales Physician Assistant 410 Celebration Pl Ste 200, Celebration, FL 34747-5432 2019-07-22
1922582147 Vanessa Yvette Hernandez Physician Assistant 410 Celebration Pl Ste 305, Celebration, FL 34747-5436 2018-09-24
1831601517 Aaliya Ali Physician Assistant 410 Celebration Pl Ste 302, Celebration, FL 34747-5435 2017-11-02
1821532714 Erin M Donohoe Physician Assistant 410 Celebration Pl Ste 302, Celebration, FL 34747-5435 2016-12-12
1851759237 Stefoni Stratton Physician Assistant 410 Celebration Pl Ste 302, Celebration, FL 34747-5435 2016-02-01
1437528957 Marc Bryan Carmody Physician Assistant 410 Celebration Pl Ste 302, Celebration, FL 34747-5435 2015-09-15
1851627178 Crystal Young Miranda Physician Assistant 400 Celebration Pl, Celebration, FL 34747-4970 2009-10-21
1699737783 Bobby John Ardila Physician Assistant 410 Celebration Pl, Suite 200, Celebration, FL 34747-5433 2006-04-04
1265407217 Robyn M. Gardner Physician Assistant 400 Celebration Pl, Suite A140, Celebration, FL 34747-4970 2006-02-22

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1811598691 Monica Nancy Ginocchio Physician Assistant 1020 Crosspointe Dr Ste 110, Naples, FL 34110-0918 2020-11-06
1427657055 Alyson Ryall Physician Assistant 480 Ventura Pl, Vero Beach, FL 32963-4262 2020-10-24
1104436476 Forrest Joseph Steslow Physician Assistant 1971 Brandywine Rd Apt 305, West Palm Beach, FL 33409-6800 2020-08-03
1063039576 Joshua Bras Prewitt Physician Assistant 4800 Linton Blvd Ste 201, Delray Beach, FL 33445-6584 2020-06-30
1003443904 Sheila Rhinehart Physician Assistant 981 Tarpon Ave, Sebastian, FL 32958-5147 2020-03-23
1952932493 Lisel Spieler Physician Assistant 1173 Fins Up Ct, Daytona Beach, FL 32124-3719 2020-02-03
1326685991 Nikolai X Lincavage Physician Assistant 29277 Us Highway 19 N # 29277, Clearwater, FL 33761-2102 2019-12-03
1356984686 Zane K Jude Physician Assistant 1775 Linton Lake Dr, Delray Beach, FL 33445-6927 2019-10-18
1720635998 Jose R Munoz Physician Assistant 4801 Esedra Ct Apt 203, Lake Worth, FL 33467-5019 2019-08-22
1811559578 Sydney Gillen Physician Assistant 1222 S Orange Ave Fl 2, Orlando, FL 32806-1215 2019-07-02
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Competitor

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City CELEBRATION
Zip Code 34747

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Dataset Information

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.

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