VASCULAR SPECIALISTS OF LAKELAND, LLC (NPI# 1548526155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548526155 |
Entity Type | Organization |
Organization Name | VASCULAR SPECIALISTS OF LAKELAND, LLC |
Practice Address |
2125 Crystal Grove Dr Lakeland FL 33801-6875 |
Practice Telephone | 8636882334 |
Practice Fax Number | 8635771167 |
Mailing Telephone | 8636882334 |
Mailing Fax Number | 8635771167 |
Enumeration Date | 2012-04-09 |
Last Update Date | 2013-08-12 |
Authorized Official Name | EDWARD J GOODEMOTE (CEO) |
Authorized Official Telephone | 8636882334 |
Authorized Official Credential | PHD, RN |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
Street Address |
2125 CRYSTAL GROVE DR |
City | LAKELAND |
State | FL |
Zip Code | 33801-6875 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1427049931 | Radiology & Imaging Specialists of Lakeland | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2005-11-03 |
1942751813 | Teresa M Colletti | Nurse Practitioner | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2016-10-17 |
1225589179 | Rodney Shawn Carter | Nurse Practitioner | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2016-10-16 |
1467866780 | Rekhaben Ramanbhai Suthar | Anesthesiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2014-06-14 |
1801185897 | Matthew P Buzzeo | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2011-03-30 |
1336448562 | Neel D Karamsadkar | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2011-03-28 |
1811216732 | Ritu Aparajita | Surgery | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2010-05-18 |
1023248648 | Michael K Gordon | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801 | 2009-07-16 |
1871721167 | Joseph Daniel Mullen | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2009-06-25 |
1427207968 | Venkat P Tummala | Radiology | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2008-09-09 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508473802 | Camryn Nichole White | Assistant Behavior Analyst | 301 South Florida Ave, Lakeland, FL 33801 | 2020-09-30 |
1932719242 | Jimia Watkins | Home Health Aide | 2410 Lakeview St, Lakeland, FL 33801 | 2020-08-03 |
1396366886 | Erin Zimmer | Health Educator | 491 Lake Parker Ave, Lakeland, FL 33801 | 2020-05-06 |
1013473206 | Madelyn Claire Burley | Occupational Therapist | 1215 East Orange Street, Lakeland, FL 33801 | 2019-02-13 |
1992260319 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 1617 Us Highway 98 S, Lakeland, FL 33801 | 2019-02-11 |
1669908836 | Integrative Physical Medicine of Lakeland LLC | Specialist | 1205 East Magnolia St, Suite 105, Lakeland, FL 33801 | 2017-05-10 |
1689111502 | Daryl Dowding | Counselor | 390 Alcaia Rd., Lakeland, FL 33801 | 2017-01-30 |
1023481926 | Joseph D'alessandro | Specialist/Technologist | 111 Lake Hollingsworth Dr Box 4334, Lakeland, FL 33801 | 2015-11-02 |
1588030894 | Donna Lee Buckner | Specialist/Technologist | 111 Mosswood Road, Lakeland, FL 33801 | 2015-08-20 |
1144635780 | Donna Paige Mccraney | Nurse Practitioner | 111 Lake Hollingsworth Drive, Florida Southern College Student Health Center, Lakeland, FL 33801 | 2014-06-23 |
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Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528363041 | Rapha Vascular Specialists Inc. | Surgery | 1619 Harden Blvd, Lakeland, FL 33803-1826 | 2011-01-13 |
1689196248 | Vein & Vascular Experts, Pllc | Surgery | 5907 Hillside Heights Dr., Lakeland, FL 33812 | 2017-07-14 |
1558775874 | Tushar Champaklal Barot | Surgery | 1305 Lakeland Hills Blvd, Lakeland, FL 33805-4542 | 2014-06-14 |
1811216732 | Ritu Aparajita | Surgery | 2125 Crystal Grove Dr, Lakeland, FL 33801-6875 | 2010-05-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104394857 | George Scott Hall Sr. | Surgery | 9 Marsh Creek Rd, Fernandina Beach, FL 32034-6413 | 2018-11-09 |
1316413115 | Fox Vascular Experts, LLC | Surgery | 2699 Stirling Rd Ste A301302, Fort Lauderdale, FL 33312-6517 | 2018-10-18 |
1114417508 | Vascular Center of Naples Inc. | Surgery | 5490 Bryson Dr Ste 201, Naples, FL 34109 | 2018-05-11 |
1598267593 | Joseph D Stillword, Md | Surgery | 800 Zeagler Dr Ste 320, Palatka, FL 32177-3827 | 2018-03-06 |
1386157006 | Beatriz Lam | Surgery | 2001 West 68 St, Cvicu, Hialeah, FL 33016 | 2017-11-16 |
1811421092 | Sunrise Vascular Center | Surgery | 8555 Nw 165th Ter, Miami Lakes, FL 33016-6138 | 2017-04-14 |
1962891838 | Global Trauma Systems, Inc | Surgery | 126 Se Mira Lavella, Port Saint Lucie, FL 34984-6615 | 2015-01-15 |
1184013450 | Vas-q-lar, Inc | Surgery | 6187 Nw 167th St, Suite H13, Hialeah, FL 33015-4340 | 2015-01-09 |
1396147138 | Usa Vein Clinics of Miami, LLC | Surgery | 1711 E Hallandale Beach Blvd Ste B, Hallandale Beach, FL 33009-4621 | 2014-09-24 |
1114336021 | Florida Vein Center, Inc | Surgery | 6050 53rd Ave E Unit A, Bradenton, FL 34203-9700 | 2014-08-05 |
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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.