IDL MEDICAL PA (NPI# 1487839635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487839635 |
| Entity Type | Organization |
| Organization Name | IDL MEDICAL PA |
| Practice Address |
10075 Jog Rd Suite 101 Boynton Beach FL 33437-3535 |
| Practice Telephone | 5617345484 |
| Practice Fax Number | 5617345485 |
| Mailing Telephone | 5617345484 |
| Mailing Fax Number | 5617345485 |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2008-07-31 |
| Authorized Official Name | DR. DIANA GOROKHOVKSY (PRESIDENT) |
| Authorized Official Telephone | 3057255529 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
10075 JOG RD SUITE 101 |
| City | BOYNTON BEACH |
| State | FL |
| Zip Code | 33437-3535 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467497529 | Florida Eye & Plastic Surgery Associates Inc | Ophthalmology | 10075 Jog Rd, Suite 301, Boynton Beach, FL 33437-3535 | 2006-06-20 |
| 1811155377 | Leavitt Medical Associates of Florida Inc | Dermatology | 10075 Jog Rd, Suite 203, Boynton Beach, FL 33437-3535 | 2008-05-30 |
| 1003090937 | Ira Spinner Dpm Pa | Podiatrist | 10075 Jog Rd, Ste 208, Boynton Beach, FL 33437-3536 | 2007-12-27 |
| 1366639262 | Angelos Koutsonikolis Md Pa | Allergy & Immunology | 10075 Jog Rd, Suite 100, Boynton Beach, FL 33437-3535 | 2007-09-25 |
| 1982728705 | Diana Gorokhovsky | Family Medicine | 10075 Jog Rd, Suite 101, Boynton Beach, FL 33437-3535 | 2007-03-19 |
| 1356475628 | Susan Beth Leifer | Nurse Practitioner | 10075 Jog Rd, Suite 203, Boynton Beach, FL 33437-3535 | 2007-03-16 |
| 1407980105 | Ira Martin Fine Mdpa | Internal Medicine | 10075 Jog Rd, Suite 202, Boynton Beach, FL 33437-3535 | 2007-03-15 |
| 1174695332 | Jeffrey S Schottland, Md Pa | Otolaryngology | 10075 Jog Rd, Suite 107, Boynton Beach, FL 33437-3535 | 2006-11-14 |
| 1972688612 | Deborah Ullian Kashdan | Physician Assistant | 10075 Jog Rd, Suite 108, Boynton Beach, FL 33437-3535 | 2006-10-25 |
| 1851473524 | Kathleen P Kurit | Nurse Practitioner | 10075 Jog Rd, Suite 207, Boynton Beach, FL 33437-3535 | 2006-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548800808 | Ortho Florida, LLC | Anesthesiology | 11135 S Jog Road Ste 5, Boynton Beach, FL 33437 | 2020-01-14 |
| 1730725086 | Uttamkumar Sheladiya | Pharmacist | 12080 South Jog Rod, Boyton Beach, FL 33437 | 2019-11-21 |
| 1831601608 | Sheri Keehn | Nurse Practitioner | 6713 Conch Ct, Boynton Beach, FL 33437 | 2017-11-01 |
| 1265958037 | Kiersten Lutchi | Behavior Technician | 7862 Red Mahogany Road, Boynton Beach, FL 33437 | 2017-08-14 |
| 1740725084 | Marie Maxi | Behavior Technician | 6713 Heritage Grande, 1206, Boynton Beach, FL 33437 | 2016-12-22 |
| 1184071623 | Darronique Johnson | Technician, Other | 10779 Cambay Cr., Boynton Beach, FL 33437 | 2016-05-14 |
| 1033580709 | Brett R. Hutton, M.d., P.a. | Internal Medicine | 10301 Hagen Ranch Rd Ste B550, Boynton Beach, FL 33437 | 2015-10-07 |
| 1104258417 | Domenick Andrew Cerullo | Dentist | 10150 Hagen Ranch Road Suite 202, Dental Arts of Boynton Beach, P.a., Boynton Beach, FL 33437 | 2013-08-09 |
| 1275883399 | Kate A Vazquez | Physician Assistant | 7593 Boynton Beach Blvd Ste 190, Boynton Beach, FL 33437 | 2012-09-17 |
| 1912256009 | Kristi Joy Kline | Physical Therapist | 11135 South Jog Road, Suite 1, Boynton Beach, FL 33437 | 2012-09-05 |
| Find all providers in zip 33437 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346869237 | Guerry Cenord | Family Medicine | 7987 Clementine Dr, Boynton Beach, FL 33436-1605 | 2020-04-10 |
| 1841829512 | Christian E Sanon | Family Medicine | 1690 Renaissance Commons Blvd Apt 1301, Boynton Beach, FL 33426-7211 | 2020-04-05 |
| 1801363411 | Lisa Ann Antonczak | Family Medicine | 23 Pepperwood Ct, Boynton Beach, FL 33426-9351 | 2018-11-01 |
| 1013425727 | Latoya Camay Howell | Family Medicine | 1605 Renaissance Commons Blvd, 428, Boynton Beach, FL 33426 | 2018-01-16 |
| 1518481191 | Esther Thomas | Family Medicine | 115 Nw 14th Ave, Boynton Beach, FL 33435-2634 | 2017-07-26 |
| 1013430701 | Dawn M Sepulveda | Family Medicine | 10151 Enterprise Ctr Ste 106, Boynton Beach, FL 33437-3760 | 2017-07-25 |
| 1588186191 | Tyler J Provost | Family Medicine | 4600 N Ocean Blvd Ste 101, Boynton Beach, FL 33435-7365 | 2017-07-14 |
| 1609001106 | Trudell A Doctor | Family Medicine | 7730 Boynton Beach Blvd Ste 3, Boynton Beach, FL 33437-6155 | 2009-05-27 |
| 1265607501 | George Andricopoulos | Family Medicine | 2010 S Federal Hwy Apt I409, Boynton Beach, FL 33435-6912 | 2008-04-28 |
| 1497925085 | Donald Dunayer | Family Medicine | 5874 Crystal Shores Dr, Suite 107, Boynton Beach, FL 33437-5683 | 2008-03-10 |
| Find all providers in BOYNTON BEACH | ||||
| City | BOYNTON BEACH |
| Zip Code | 33437 |
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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.