RETINA ASSOCIATES PA (NPI# 1619958352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619958352 |
| Entity Type | Organization |
| Organization Name | RETINA ASSOCIATES PA |
| Practice Address |
2 Shircliff Way Suite 715 Jacksonville FL 32204-4753 |
| Practice Telephone | 9043888446 |
| Practice Fax Number | 9043846261 |
| Mailing Telephone | 9043888446 |
| Mailing Fax Number | 9043846261 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2011-06-13 |
| Authorized Official Name | DR. FRED H LAMBROU JR. (PRESIDENT) |
| Authorized Official Telephone | 9043888446 |
| Authorized Official Credential | M D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | ME0053221 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE | 18BDCCP | 01 |
| FL | 048036300 | 05 | |
| FL | BLUE CROSS/BLUE SHIELD | 05860 | 01 |
| RAILROAD MEDICARE | 180005784 | 01 | |
| RAILROAD MEDICARE | C12098 | 01 | |
| GA | MEDICAID | 00394479A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609818913 | Retina Associates Pa | Specialist | 9301 W 74th St, Suite 210, Shawnee Mission, KS 66204-2207 | 2006-06-12 |
| Street Address |
2 SHIRCLIFF WAY SUITE 715 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-4753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972508356 | Suprith Badarinath | Internal Medicine | 2 Shircliff Way, Ste 800, Jacksonville, FL 32204-4751 | 2005-06-14 |
| 1841656105 | Rita Marie Border | Nurse Practitioner | 2 Shircliff Way, #300, Jacksonville, FL 32204-4753 | 2016-01-01 |
| 1295128817 | Alexandra Eleanor Michaelis | Nurse Practitioner | 2 Shircliff Way, Suite 700 Depaul Bldg., Jacksonville, FL 32204-4763 | 2015-03-05 |
| 1538558028 | Carole Faria | Registered Nurse | 2 Shircliff Way, Suite 900, Jacksonville, FL 32204-4753 | 2015-01-21 |
| 1609265107 | Teresa Braddy | Registered Nurse | 2 Shircliff Way, Suite 900, Jacksonville, FL 32204-4753 | 2015-01-21 |
| 1235533829 | Heekin Clinic LLC | Orthopaedic Surgery | 2 Shircliff Way, Ste 605 Depaul Building, Jacksonville, FL 32204-4753 | 2014-10-10 |
| 1851710404 | Juan Chique Figueroa | Internal Medicine | 2 Shircliff Way, Suite 700 Depaul Bldg., Jacksonville, FL 32204 | 2014-04-10 |
| 1295151348 | Harris, Wilcox & Donovan Pa | Ophthalmology | 2 Shircliff Way, Suite 120, Jacksonville, FL 32204-4753 | 2014-03-13 |
| 1568800613 | Sara Marie Preston | Nurse Practitioner | 2 Shircliff Way, Ste 700 Depaul Bldg., Jacksonville, FL 32204-4763 | 2013-06-11 |
| 1851735187 | Lori Elizabeth Jones-taylor | Pharmacist | 2 Shircliff Way, Jacksonville, FL 32204-4753 | 2013-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790216729 | Kumar Sambhav | Ophthalmology | 580 W 8th Street, Tower - II, 3rd Floor, Department of Ophthalmology, Jacksonville, FL 32209 | 2017-03-22 |
| 1306227335 | Sepehr Bahadorani | Ophthalmology | 580 W 8th St Fl Towerii3, Uf College of Medicine - Jacksonville, Jacksonville, FL 32209-6533 | 2015-06-16 |
| 1467854240 | Mohammed Ali Tawfik Alyouzbaki | Ophthalmology | 6054 Wateredge Drive South, Jacksonville, FL 32211 | 2014-09-23 |
| 1841580214 | Chad Michael Kaplan | Ophthalmology | 653 West 8th St, Jacksonville, FL 32209 | 2011-04-19 |
| 1730479650 | Abdallah Mohamed Jeroudi | Ophthalmology | 2639 Oak St, Jacksonville, FL 32204 | 2011-04-12 |
| 1881915619 | Omar Gayasaddin | Ophthalmology | 7051 Southpoint Pkwy S Fl 3, Jacksonville, FL 32216-8713 | 2010-06-16 |
| 1952630121 | Ralph Alphonse Sawyer | Ophthalmology | 10061 Lakes End Ct, Jacksonville, FL 32256-4112 | 2009-12-16 |
| 1326193020 | Midwest Eye Associates, LLC | Ophthalmology | 1122 Veterans Dr, Suite B, Jacksonville, IL 62650-4032 | 2007-01-24 |
| 1023118379 | Jeffrey Herschel Levenson | Ophthalmology | 751 Oak St Ste 200, Jacksonville, FL 32204-3361 | 2006-09-25 |
| 1942317680 | Gerard A. Coluccelli | Ophthalmology | 931 Brookwood Rd, Jacksonville, FL 32207-4211 | 2006-08-25 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.