DR. DAMIAN CHARLES HANEKOM (NPI# 1508211947) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508211947 |
| Entity Type | Individual |
| Full Name | DR. DAMIAN CHARLES HANEKOM |
| Credential | M.D. |
| Practice Address |
2441 Surfside Blvd Ste 200 Cape Coral FL 33914-3861 |
| Mailing Address |
180 Harvester Dr Ste 110 Burr Ridge IL 60527-6686 |
| Practice Telephone | 2394241499 |
| Mailing Telephone | 7737021150 |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2019-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ME139796 | FL | Allopathic & Osteopathic Physicians |
| Y | 207Q00000X | Family Medicine | 125.068045 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2650 Ridge Ave, Ste 1304, Evanston, IL 602011718 | 8476571820 |
| Street Address |
2441 SURFSIDE BLVD STE 200 |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33914-3861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578550026 | Bharath Radhakrishna | Internal Medicine | 2441 Surfside Blvd Ste 200, Cape Coral, FL 33914-3861 | 2005-09-30 |
| 1922585066 | Melisa Maria Rodriguez | Nurse Practitioner | 2441 Surfside Blvd Ste 200, Cape Coral, FL 33914-3861 | 2018-07-22 |
| 1144719246 | Michael Anthony Parks | Nurse Practitioner | 2441 Surfside Blvd Ste 200, Cape Coral, FL 33914 | 2018-05-03 |
| 1316466642 | Laryn Elise Mertz | Nurse Practitioner | 2441 Surfside Blvd Ste 200, Cape Coral, FL 33914-3861 | 2017-09-19 |
| 1689939282 | Susan C Mason | Nurse Practitioner | 2441 Surfside Blvd Ste 200, Cape Coral, FL 33914-3861 | 2012-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477019388 | Total Renal Care Inc | Clinic/Center | 4539 Chiquita Blvd S, Cape Coral, FL 33914 | 2019-02-15 |
| 1316310303 | Alejandra Romero | Dentist | 1715 Cape Coral Parkway West.suite #13, Cape Coral, FL 33914 | 2015-11-12 |
| 1366826141 | Hannah M Dowling | Nurse Practitioner | 2441 Surfside Blvd., Cape Coral, FL 33914 | 2015-07-12 |
| 1003181389 | Yosmel O Carrasco | Massage Therapist | 3910 Santa Barbara Blvd 103, Cape Coral, FL 33914 | 2012-03-20 |
| 1326330507 | Taylor's Exceptional Nurse Practitioner Service, LLC | Nurse Practitioner | 841 Sw 47th Ter #106, Cape Coral, FL 33914 | 2011-05-06 |
| 1407010226 | Carmelita Buenviaje Almazan | Case Manager/Care Coordinator | 4334 Sw 9th Avenue, Cape Coral, FL 33914 | 2008-07-10 |
| 1447471503 | Daysi Perez | Massage Therapist | 4624 Sw 14 Ave, Cape Coral, FL 33914 | 2007-05-02 |
| 1801973466 | Russell Meredith Fidler | Dentist | 1616 W Cape Coral Parkway Unit #115, Cape Coral, FL 33914 | 2006-11-01 |
| 1134226814 | Elizabeth Elia | Dentist | 415 Cape Coral Parkway #w1, Cape Coral, FL 33914 | 2006-09-17 |
| 1225140718 | Dental Associates of Cape Coral, Pa | Dentist | 1715 Cape Coral Parkway West, Suite 11, Cape Coral, FL 33914 | 2006-08-31 |
| Find all providers in zip 33914 | ||||
| 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 |
|---|---|---|---|---|
| 1013535103 | Manuel Lorenzo Romero Garcia | Family Medicine | 1123 Se 19th Ln, Cape Coral, FL 33990-4532 | 2020-07-06 |
| 1548809551 | Medical Risk Solutions | Family Medicine | 1020 Cultural Park Blvd, Cottage #7, Cape Coral, FL 33990 | 2019-12-23 |
| 1184126252 | Trc Medical Practices Inc. | Family Medicine | 3321 Del Prado Blvd S Ste 3, Cape Coral, FL 33904-7263 | 2018-03-05 |
| 1871015693 | Remberto Lopez Md Pa | Family Medicine | 814 Sw Pine Island Rd Ste 306, Cape Coral, FL 33991-1943 | 2017-07-13 |
| 1083153761 | Juan Antonio Carmona | Family Medicine | 2307 Bolado Pkwy, Cape Coral, FL 33990-2712 | 2017-02-15 |
| 1134589286 | Sunshine Family Doctor LLC | Family Medicine | 4831 Coronado Pkwy, Cape Coral, FL 33904-9516 | 2016-03-02 |
| 1861881997 | Romulo Bernal | Family Medicine | 3925 Del Prado Blvd S, Cape Coral, FL 33904-7130 | 2015-01-13 |
| 1790184356 | Rx Imaging of Swfl, LLC | Family Medicine | 506 Se 47th St Suite A, Cape Coral, FL 33904 | 2014-08-20 |
| 1265842231 | Trevor E. Cox | Family Medicine | 1708 Cape Coral Pkwy W Ste 6, Cape Coral, FL 33914-6985 | 2014-04-30 |
| 1508107244 | Family Care 1 LLC | Family Medicine | 1411 Se 16th Pl, Cape Coral, FL 33990 | 2013-03-05 |
| Find all providers in CAPE CORAL | ||||
| City | CAPE CORAL |
| Zip Code | 33914 |
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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.