JUSTIN ALLAN WILLIS (NPI# 1619420536) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619420536 |
| Entity Type | Individual |
| Full Name | JUSTIN ALLAN WILLIS |
| Credential | IDC |
| Practice Address |
8353 Iris Ave Seminole FL 33777-3643 |
| Practice Telephone | 7272884516 |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-07-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
W4204214450 | FL | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003186446 | Justin Ryan Willis | Massage Therapist | 12409 Albion St, Thornton, CO 80241-2932 | 2012-01-03 |
| 1699312173 | Justin Wayne Willis | Chiropractor | 225 N Causeway, New Smyrna Beach, FL 32169-5239 | 2019-12-04 |
| 1841723681 | Justin Lawrence Willis | Pediatrics | 528 Chief Eddie Hoffman Hwy, Bethel, AK 99559 | 2017-04-08 |
| 1639501588 | Justin Kyle Willis | Chiropractor | 2829 Dallas St Nw, Kennesaw, GA 30144-2705 | 2013-08-02 |
| Street Address |
8353 IRIS AVE |
| City | SEMINOLE |
| State | FL |
| Zip Code | 33777-3643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649824194 | Michael Abenoja | Chiropractor | 9824 83rd Street, Seminole, FL 33777 | 2019-08-01 |
| 1922585405 | Patricia Ann Nickol | Developmental Therapist | 8988, 79th Ave N, Seminole, FL 33777 | 2018-07-26 |
| 1558748855 | Angel Flights, LLC | Ambulance | 10294 Shady Oak Lane, Seminole, FL 33777 | 2015-05-06 |
| 1831583350 | Cecilia Leticia Chandler | Nurse Practitioner | 9048 109th Terrace North, Largo, FL 33777 | 2015-03-23 |
| 1699024596 | Betsy Silverio | Social Worker | 8700 Flamevine Ave, Seminole, FL 33777 | 2012-09-06 |
| 1881965655 | Kayte Clifford | Speech-Language Pathologist | 9035 Bryan Dairy Road, Largo, FL 33777 | 2012-01-25 |
| 1750666913 | Lawrence Daniel Williams | Surgery | 8235 Lapin Ct., Seminole, FL 33777 | 2011-10-19 |
| 1033433107 | Josephine C Eligado | Anesthesiology | 8764 Baywood Park Drive, Seminole, FL 33777 | 2010-03-18 |
| 1811222847 | Clearwater Surgical Associates, Pllc | Surgery | 8839 Bryan Dairy Road, Suite 310, Largo, FL 33777 | 2009-10-08 |
| 1811154826 | Joseph J Arvilla | Registered Nurse | 9476 88th Terrace North, Seminole, FL 33777 | 2008-05-19 |
| Find all providers in zip 33777 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831729821 | Michael O'connell | Military Health Care Provider | 8201 Bardmoor Pl Apt 203d, Seminole, FL 33777-1327 | 2020-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740803725 | Alanna Gonzalez | Military Health Care Provider | 1453 Lindseys Crossing Dr, Jacksonville, FL 32218-8088 | 2020-05-25 |
| 1538793849 | Alberto Kris Cipollone | Military Health Care Provider | Bon Homme Richard Ave Bldg 2480, Jacksonville, FL 32246-0046 | 2020-02-25 |
| 1376175794 | James Ernest Claypool | Military Health Care Provider | 12411 Glenn Hollow Dr, Jacksonville, FL 32226-2349 | 2020-02-05 |
| 1508404062 | Anthony Briel | Military Health Care Provider | 305 S Crag Road, Panama City, FL 32444 | 2019-12-16 |
| 1043863079 | Jenny Lee Mahoney | Military Health Care Provider | 55281 Yellow Jacket Dr, Callahan, FL 32011-8534 | 2019-07-18 |
| 1023546108 | Gregory Donald Willden | Military Health Care Provider | Bon Homme Richard St, Bldg 2480, Jacksonville, FL 32228 | 2017-06-01 |
| 1992230429 | George Williams Osorio | Military Health Care Provider | 1734 Forest Lakes Cir Apt D, West Palm Beach, FL 33406-5773 | 2017-04-21 |
| 1235681545 | Huriel A Rivera Aponte | Military Health Care Provider | Naval Station Mayport, Surflant Medical Readiness Division Detachment Mayport, Jacksonville, FL 32228 | 2016-11-03 |
| 1720531635 | Julian Vincent | Military Health Care Provider | 3861 Aubrey Ln, Orange Park, FL 32065-8224 | 2016-07-27 |
| 1750733853 | William Henry Meyers IIi | Military Health Care Provider | 1608 Pine Mark Ct, Fleming Island, FL 32003-7215 | 2016-07-13 |
| Find all providers with the same taxonomy | ||||
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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.