TIERNEY REGAN BOTTINO (NPI# 1508474370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508474370 |
Entity Type | Individual |
Full Name | TIERNEY REGAN BOTTINO |
Practice Address |
3650 Colonial Ct Fort Myers FL 33913-6636 |
Mailing Address |
4 Emerson Pl Apt Th3 Boston MA 02114-2287 |
Practice Telephone | 2392746070 |
Mailing Telephone | 8156850980 |
Enumeration Date | 2020-07-17 |
Last Update Date | 2020-07-17 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Address | Telephone Number | Fax Number |
---|---|---|
4 Emerson Pl Apt Th3, Boston, MA 021142287 | 8156850980 |
Street Address |
3650 COLONIAL CT |
City | FORT MYERS |
State | FL |
Zip Code | 33913-6636 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720376569 | Robert M Hawkes | Physician Assistant | 3650 Colonial Ct, Fort Myers, FL 33913-6636 | 2011-07-14 |
1124679501 | Kala Garth | Physician Assistant | 3650 Colonial Ct, Fort Myers, FL 33913-6636 | 2019-09-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1467079368 | Fq0014 | Clinic/Center | 11930 Fairway Lakes Dr, Ste 103, Fort Myers, FL 33913 | 2020-06-26 |
1386272334 | Chrysallis Wellness Center Inc | Counselor | 11932 Faiway Lakes, Fort Myers, FL 33913 | 2020-03-27 |
1811459399 | Kelly Christine Reynolds | Student in an Organized Health Care Education/Training Program | 11750 Rosemount Drive, Fort Myers, FL 33913 | 2019-04-03 |
1043784432 | Alex Richard Reynolds | Physician Assistant | 2700 Creekside Ln, Suit 101, Fort Myers, FL 33913 | 2019-01-18 |
1881196541 | Kara Seanor | Counselor | 12575 Stone Tower Loop, Fort Myers, FL 33913 | 2018-03-08 |
1063951515 | Publix Super Markets Inc | Durable Medical Equipment & Medical Supplies | 13121 Paul J. Doherty Pkwy, Fort Myers, FL 33913 | 2017-02-16 |
1518337492 | Barry K Butler P.a. | Internal Medicine | 10708 Bradbury Way, Fort Myers, FL 33913 | 2015-10-05 |
1811322886 | Bernard Timothy Renner | Pharmacist | 10000 Gulf Coast Town Center Drive, Ft. Myers, FL 33913 | 2013-09-10 |
1831531979 | Debra Anne Channer | Pharmacist | 12550 Professional Park Drive Unit 1, Walgreens Co., Ft. Myers, FL 33913 | 2013-07-17 |
1144572249 | Victoria Sydeco Tayengco-maisog | Pediatrics | 9304 Trieste Drive, Fort Myers, FL 33913 | 2012-10-12 |
Find all providers in zip 33913 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881213833 | Seemal Sanjana Kumar | Student in an Organized Health Care Education/Training Program | 3000 Oasis Grand Blvd Apt 903, Fort Myers, FL 33916-1599 | 2020-04-09 |
1548898703 | Alejandro Garcia | Student in an Organized Health Care Education/Training Program | 5553 Whispering Willow Way, Fort Myers, FL 33908-4511 | 2020-03-31 |
1134780646 | Ximena Hurtado | Student in an Organized Health Care Education/Training Program | 17391 Sterling Lake Dr, Fort Myers, FL 33967-7221 | 2019-06-25 |
1790341030 | Alaina Terez Todd | Student in an Organized Health Care Education/Training Program | 17007 Wrigley Cir, Fort Myers, FL 33908-3802 | 2019-05-13 |
1811450240 | Ana Carolina D Barbosa | Student in an Organized Health Care Education/Training Program | 8960 Dorchester St, Fort Myers, FL 33907-5911 | 2019-04-11 |
1811459399 | Kelly Christine Reynolds | Student in an Organized Health Care Education/Training Program | 11750 Rosemount Drive, Fort Myers, FL 33913 | 2019-04-03 |
1275068769 | Maia Dunn | Student in an Organized Health Care Education/Training Program | 9673 Bay Harbor Cir, Apt 204, Fort Myers, FL 33919-5721 | 2017-04-21 |
1770016636 | Alexandra Marie Menillo | Student in an Organized Health Care Education/Training Program | 9679 Bay Harbor Cir Apt 203, Fort Myers, FL 33919-5723 | 2017-04-07 |
1841676590 | Gary Pham | Student in an Organized Health Care Education/Training Program | 1741 Red Cedar Drive Apt 20, Fort Myers, FL 33907 | 2015-08-05 |
1477153229 | Evalenee Marie Feutz | Student in an Organized Health Care Education/Training Program | 9981 S Healthpark Dr, Fort Myers, FL 33908-3618 | 2020-10-30 |
Find all providers in FORT MYERS |
City | FORT MYERS |
Zip Code | 33913 |
Please comment or provide details below to improve the information on TIERNEY REGAN BOTTINO.
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.