JUSTIN BOCCARDO (NPI# 1598887275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598887275 |
| Entity Type | Individual |
| Full Name | JUSTIN BOCCARDO |
| Credential | M.D. |
| Practice Address |
2401 Frist Blvd Ste 4 Fort Pierce FL 34950-4800 |
| Practice Telephone | 7725955302 |
| Practice Fax Number | 7725955304 |
| Mailing Telephone | 7725955302 |
| Mailing Fax Number | 7725955304 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-01-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
ME125876 | FL | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
MD432316 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 102479013 0001 | 05 |
| Street Address |
2401 FRIST BLVD STE 4 |
| City | FORT PIERCE |
| State | FL |
| Zip Code | 34950-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669565693 | Danielle Dean | Physician Assistant | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2006-10-02 |
| 1841805686 | Leslie Ann Cooper | Physician Assistant | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2020-09-09 |
| 1255813911 | David Mcneely Roberts | Physician Assistant | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950 | 2018-08-29 |
| 1356665251 | Bo Wang | Surgery | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2010-03-22 |
| 1922275866 | Christopher L Binette | Surgery | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2008-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659853018 | New Day Counseling & Wellness, LLC | Clinic/Center | 130 S Indian River Drive Suite 202, Fort Pierce, FL 34950 | 2018-09-03 |
| 1548749351 | Jaber's Pharmacy, Inc. | Pharmacy | 2210 Orange Ave, Fort Pierce, FL 34950 | 2018-08-13 |
| 1386139699 | Pas Substance Abuse, Inc. | Substance Abuse Rehabilitation Facility | 2017 Avenue D, Fort Pierce, FL 34950 | 2018-06-28 |
| 1629573134 | Southeastern Dme LLC | Durable Medical Equipment & Medical Supplies | 200 S Indian River Dr Ste 300, Fort Pierce, FL 34950 | 2018-03-27 |
| 1962903666 | Serenity Dme LLC | Durable Medical Equipment & Medical Supplies | 111 N 2nd St Ste 101, Fort Pierce, FL 34950 | 2018-02-27 |
| 1417463068 | Ryan Nippes | Counselor | 1302 N Lawnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1639685282 | Valencia Worrell | Counselor | 1302 N Lswnwood Cr, Suite B, Fort Pierce, FL 34950 | 2017-12-19 |
| 1194173153 | Angel French | Massage Therapist | 101 North Us1, Suite 117, Fort Pierce, FL 34950 | 2016-06-01 |
| 1780052951 | Alison Hess | Physician Assistant | 1700 S. 23rd St, Fort Pierce, FL 34950 | 2015-09-04 |
| 1629329784 | Dr. Rhaina A Smeds, Psyd Inc. | Psychologist | 100 Ave A, Ste 2d, Ft. Pierce, FL 34950 | 2012-09-28 |
| Find all providers in zip 34950 | ||||
| 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 |
|---|---|---|---|---|
| 1437144870 | Kenneth G Bridges | Surgery | 2402 Frist Blvd, Suite 203, Fort Pierce, FL 34950-4838 | 2005-09-13 |
| 1356665251 | Bo Wang | Surgery | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2010-03-22 |
| 1922275866 | Christopher L Binette | Surgery | 2401 Frist Blvd Ste 4, Fort Pierce, FL 34950-4800 | 2008-05-09 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | FORT PIERCE |
| Zip Code | 34950 |
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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.