GOMA MAYBERRY (NPI# 1588101174) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588101174 |
| Entity Type | Individual |
| Full Name | GOMA MAYBERRY |
| Practice Address |
773 Riverside Dr Ormond Beach FL 32176-7878 |
| Practice Telephone | 3867952457 |
| Mailing Telephone | 3867952457 |
| Enumeration Date | 2017-01-20 |
| Last Update Date | 2017-01-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN9308893 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
773 RIVERSIDE DR |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32176-7878 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912488446 | Laura Kuftic | Massage Therapist | 496 Hollywood Street, None, Ormond Beach, FL 32176 | 2018-08-23 |
| 1154809846 | Thomas Dubrule | Technician, Pathology | 176 Ormwood Dr, Ormond Beach, FL 32176 | 2018-08-03 |
| 1326590316 | Rsc Ormond Beach Seaside LLC | Assisted Living Facility | 1050 Ocean Short Blvd, Ormond Beach, FL 32176 | 2016-10-26 |
| 1114270717 | Kristi L Lafreniere | Nurse Practitioner | 215 Ponce De Leon Drive, Ormond Bch, FL 32176 | 2012-10-19 |
| 1043589922 | Jocelyn Marie Mazelow | Pharmacist | 205 E Granada Blvd., Ormond Beach, FL 32176 | 2011-12-21 |
| 1437390630 | Neal Galen Henegar | Massage Therapist | 195 Coquina Court, Ormond Beach, FL 32176 | 2009-03-18 |
| 1669612602 | Margarita J. Vagnier | Occupational Therapy Assistant | 3 Briggs Drive, Ormond Beach, FL 32176 | 2009-03-04 |
| 1063676278 | Elaine C Murphy | Chore Provider | 129 Beau Rivage Drive, Ormond Beach, FL 32176 | 2008-07-16 |
| 1063575017 | Carol Lynn Learned | Chiropractor | 147 East Granada Blvd, Ormond Beach, FL 32176 | 2006-12-19 |
| 1730132044 | Charles Thomas Donaldson | Emergency Medicine | 7 Sea Oats Terraace, Ormond Beach, FL 32176 | 2006-05-18 |
| Find all providers in zip 32176 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437763125 | Saltwater Health & Wellness LLC | Nurse Practitioner | 260 Williamson Blvd # 731498, Ormond Beach, FL 32174-8257 | 2020-09-01 |
| 1164033288 | Jenilee Marcinkiewicz | Nurse Practitioner | 915 Willow Run, Ormond Beach, FL 32174-6147 | 2020-08-12 |
| 1760002448 | Ryan E Shaw | Nurse Practitioner | 725 W. Granada Blvd, Ste 22, Ormond Beach, FL 32174-5107 | 2020-04-22 |
| 1265929343 | Karen Sebastien | Nurse Practitioner | 1503 Oak Forest Dr, Ormond Beach, FL 32174-3409 | 2018-04-15 |
| 1346750205 | Laura Lyann Gonzalez | Nurse Practitioner | 13 Walnut Ln, Ormond Beach, FL 32174-2618 | 2017-10-05 |
| 1154712941 | Margaret Craddock | Nurse Practitioner | 345 Clyde Morris Blvd Ste 490, Ormond Beach, FL 32174-3114 | 2015-02-15 |
| 1063843118 | Pamela Weiker | Nurse Practitioner | 62 Mayfield Cir, Ormond Beach, FL 32174-5933 | 2013-11-27 |
| 1740586288 | Kellie Kilpatrick Battillo | Nurse Practitioner | 76 S St Andrews Dr, Ormond Beach, FL 32174-3857 | 2011-02-01 |
| 1033365143 | Robyn Panther Gleason | Nurse Practitioner | 136 Hilldale Ave, Ormond Beach, FL 32176-5724 | 2008-08-09 |
| 1952900953 | Saltwater Family Practice | Nurse Practitioner | 305 Clyde Morris Blvd Ste 200, Ormond Beach, FL 32174-8182 | 2020-10-21 |
| Find all providers in ORMOND BEACH | ||||
| City | ORMOND BEACH |
| Zip Code | 32176 |
Please comment or provide details below to improve the information on GOMA MAYBERRY.
| 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.