WATERSIDE MEDICAL LLC (NPI# 1518205038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518205038 |
| Entity Type | Organization |
| Organization Name | WATERSIDE MEDICAL LLC |
| Practice Address |
311 9th St N Naples FL 34102-5885 |
| Mailing Address |
5064 Seashell Ave Naples FL 34103-2428 |
| Practice Telephone | 2392934140 |
| Practice Fax Number | 2392543105 |
| Mailing Telephone | 2392934140 |
| Mailing Fax Number | 2392543105 |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-08-22 |
| Authorized Official Name | MATTHEW L BLACK (MANAGER) |
| Authorized Official Telephone | 2392934140 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
M80046 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE 855-B | HG441A | 01 |
| Street Address |
311 9TH ST N |
| City | NAPLES |
| State | FL |
| Zip Code | 34102-5885 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427041623 | Naples Surgical Associates Pa | Surgery | 311 9th St N, #308, Naples, FL 34102-5885 | 2005-08-24 |
| 1730629718 | Ashley Ruffing | Nurse Practitioner | 311 9th St N, Naples, FL 34102-5885 | 2017-02-24 |
| 1679949606 | Interventional Rehabilitation of South Florida, Inc. | Anesthesiology | 311 9th St N, #200, Naples, FL 34102-5885 | 2015-08-13 |
| 1912323460 | John F Alburger Md Pa | Otolaryngology | 311 9th St N, Suite 210, Naples, FL 34102-5887 | 2014-03-07 |
| 1760753636 | Maged Mokhtar Bakr | Internal Medicine | 311 9th St N, Ste 304, Naples, FL 34102-5885 | 2012-01-24 |
| 1891070298 | Michele Kmieciak Anand | Nurse Practitioner | 311 9th St N, Suite 304, Naples, FL 34102-5885 | 2011-10-17 |
| 1558416867 | Cartrell James Cross | Internal Medicine | 311 9th St N, #100, Naples, FL 34102-5885 | 2007-01-24 |
| 1376582247 | Carla Mills | Nurse Practitioner | 311 9th St N, Suite 310, Naples, FL 34102-5885 | 2006-06-06 |
| 1245296813 | Gary D Swain | Family Medicine | 311 9th St N, Suite 304, Naples, FL 34102-5885 | 2006-04-24 |
| 1104881341 | Collier Heart Group, Pllc | Internal Medicine | 311 9th St N, Suite 304, Naples, FL 34102-5885 | 2006-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710482948 | Aktive Motion Physical Therapy Inc | Clinic/Center | 1250 9th St N Ste 204, Naples, FL 34102 | 2018-03-28 |
| 1912428632 | Daily Care At Home, LLC | Home Health | 180 9th Street South, Suite 200, Naples, FL 34102 | 2017-07-03 |
| 1760737365 | Family Private Care Inc | Home Health | 1008 Goodlette Frank Rd N, Ste 201, Naples, FL 34102 | 2012-07-19 |
| 1013205384 | Valerie Jean Bress | Nurse Practitioner | 350 7th Street, Naples Community Hospital, Naples, FL 34102 | 2011-07-20 |
| 1154573830 | Gustavo D Rivera | Internal Medicine | 1064 Goodlette Road, Naples, FL 34102 | 2008-10-14 |
| 1881872281 | Proscan Imaging Naples, LLC | Radiology | 260 Tamiami Trail N, Naples, FL 34102 | 2008-02-07 |
| 1053595017 | Marlene Ann Diaczynsky | Registered Nurse | 350 7th Street North, Naples Community Hospital, Naples, FL 34102 | 2007-12-26 |
| 1699958330 | Georgiena Cobb | Counselor | 501 Goodlette Rd, Naples, FL 34102 | 2007-12-17 |
| 1124210158 | Maranatha Home Care, Inc. | Registered Nurse | 1164 Goodlette Road, Naples, FL 34102 | 2007-08-14 |
| 1669678645 | Naples Family Dentistry Inc | Dentist | 2176 Tamiami Trail North, Naples, FL 34102 | 2007-06-26 |
| Find all providers in zip 34102 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740556679 | David Sean Greschler | Anesthesiology | 1250 Pine Ridge Rd Ste 200, Naples, FL 34108-8913 | 2012-03-26 |
| 1578883732 | Glenn M Flanagan II | Anesthesiology | 2950 Tamiami Trl N Ste 13, Naples, FL 34103-4420 | 2010-06-09 |
| 1124116710 | Naples Anesthesia & Pain Associates Inc | Anesthesiology | 840 111th Avenue North, Suite 7, Naples, FL 34108-1877 | 2006-10-10 |
| 1003885831 | Sheldon K Cho | Anesthesiology | 4513 Executive Dr, Naples, FL 34119 | 2006-03-15 |
| 1629069596 | Robert A Statfeld | Anesthesiology | 1336 Creekside Blvd, Suite 1, Naples, FL 34108-1931 | 2005-10-31 |
| 1669463501 | Michael Gerald Barile | Anesthesiology | 15495 Tamiami Trl N, Suite 119, Naples, FL 34110-6206 | 2005-10-31 |
| 1831180702 | Thomas L Cook | Anesthesiology | 4949 Tamiami Trail N, Ste 206, Naples, FL 34103 | 2005-10-31 |
| 1912998808 | Stephen L Friedman | Anesthesiology | 150 Tamiami Trl N Ste 1, Naples, FL 34102 | 2005-10-31 |
| 1083604557 | Michael A Staab | Anesthesiology | 4949 Tamiami Trl N, Ste 206, Naples, FL 34103-3027 | 2005-10-26 |
| 1427600592 | Elite Pain Care, Pa | Anesthesiology | 1250 Pine Ridge Rd Ste 200, Naples, FL 34108-8913 | 2019-07-09 |
| Find all providers in NAPLES | ||||
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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.