RYAN CANTVILLE (NPI# 1508156795) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508156795 |
| Entity Type | Individual |
| Full Name | RYAN CANTVILLE |
| Credential | D.O. |
| Practice Address |
2606 Park St Jacksonville FL 32204-4520 |
| Practice Telephone | 9043884646 |
| Practice Fax Number | 9043889017 |
| Mailing Telephone | 9043884646 |
| Mailing Fax Number | 9043889017 |
| Enumeration Date | 2011-04-09 |
| Last Update Date | 2017-04-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | OS12463 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | STATELICENSE | OS 12463 | 01 |
| Street Address |
2606 PARK ST |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487625398 | Nan S Mcclelland | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2006-01-30 |
| 1124334156 | Kerry Lynn Ebueng | Nurse Practitioner | 2606 Park St, Jacksonville, FL 32204-4520 | 2010-08-27 |
| 1821314683 | Cathleen Helena Southall | Nurse Practitioner | 2606 Park St, Jacksonville, FL 32204-4520 | 2010-04-19 |
| 1043346745 | Jacksonville Pediatrics | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2007-02-26 |
| 1750352647 | Randolph E Thornton | Pediatrics | 2606 Park St, Jacksonville, FL 32204-4520 | 2006-01-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396369187 | Im Sulzbacher Center for The Homeless, Inc | Pediatrics | 5455 Springfield Blvd, Jacksonville, FL 32208-5166 | 2020-06-08 |
| 1609334515 | Jeremy N Harris, M.d., P.a. | Pediatrics | 3636 University Blvd S Ste B3, Jacksonville, FL 32216-4223 | 2019-03-10 |
| 1851856975 | Aksharbrahma Pa | Pediatrics | 6100 Greenland Rd Ste 301, Jacksonville, FL 32258-2626 | 2019-02-02 |
| 1184116972 | North Florida Pediatrics, Pa | Pediatrics | 9770 Old Bay Meadows Road, Suite 101, Jacksonville, FL 32256-7986 | 2018-06-06 |
| 1235654781 | Gabriella Assi, Md, LLC | Pediatrics | 5851 Saint Augustine Rd, Jacksonville, FL 32207-8015 | 2017-08-06 |
| 1417478629 | Johana Beatriz Gimenez | Pediatrics | 15 Founders Ln Ste 100, Jacksonville, IL 62650-3924 | 2017-06-28 |
| 1386185932 | Myrna B Ginter | Pediatrics | 3805 Ortega Blvd, Jacksonville, FL 32210-4415 | 2017-03-15 |
| 1831639400 | Children's Health Associates | Pediatrics | 3710 Grandy Ave, Jacksonville, FL 32207-6112 | 2017-03-02 |
| 1770039687 | Hampton Pediatrics Pa | Pediatrics | 11512 Lake Mead Ave Unit 201, Jacksonville, FL 32256-9688 | 2016-08-30 |
| 1447508478 | Starfish Pediatrics Pa | Pediatrics | 4500 Hodges Blvd, Suite 1, Jacksonville, FL 32224-2207 | 2012-08-23 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.