DR. MICHAEL J VANWAGNER (NPI# 1639551559) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639551559 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL J VANWAGNER |
| Credential | D.O. |
| Practice Address |
4500 San Pablo Rd S Jacksonville FL 32224-1865 |
| Practice Telephone | 9049532000 |
| Mailing Telephone | 9049532000 |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2020-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 5101021608 | MI | Allopathic & Osteopathic Physicians |
| Y | 207XS0114X |
Orthopaedic Surgery Specialization: Adult Reconstructive Orthopaedic Surgery |
OS16571 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
4500 SAN PABLO RD S |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-1865 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891799136 | Richard Clarke Agnew | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-06-01 |
| 1427657964 | Brianna Iannarelli | Nurse Anesthetist, Certified Registered | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-24 |
| 1538768981 | Heather Anne Dahlen | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-17 |
| 1578161717 | Szilvia Fortner | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-10-10 |
| 1265049464 | Carolyn Gonzalez | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-09-30 |
| 1467065748 | Ifeloluwa A Olutola | Family Medicine | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-26 |
| 1366055568 | Krina Dipak Vyas | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-26 |
| 1356954911 | Haleigh Diane Shelton | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-24 |
| 1215548805 | Victoria Zeilinger Reams | Pharmacist | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-16 |
| 1558971382 | Rachel Marie Hannon | Nurse Practitioner | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2020-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| Taxonomy Code | 207XS0114X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Adult Reconstructive Orthopaedic Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, adult reconstructive orthopaedic surgeons deal with reconstructive procedures such as joint arthroplasty (i.e., hip and knee), osteotomy, arthroscopy, soft-tissue reconstruction, and a variety of other adult reconstructive surgical procedures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518233956 | Joshua Dov Rogozinski | Orthopaedic Surgery | 3716 University Blvd S., Suite 3, Jacksonville, FL 32216 | 2012-03-29 |
| 1467071829 | Kim Orthopedic LLC | Orthopaedic Surgery | 2 Shircliff Way Ste 605, Jacksonville, FL 32204-4762 | 2020-04-15 |
| 1235533829 | Heekin Clinic LLC | Orthopaedic Surgery | 2 Shircliff Way, Ste 605 Depaul Building, Jacksonville, FL 32204-4753 | 2014-10-10 |
| 1427465145 | Heekin Orthopedic Joint Replacement Specialist | Orthopaedic Surgery | 2627 Riverside Ave, 3rd Floor, Jacksonville, FL 32204-4712 | 2014-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891289377 | Ortho Florida, LLC | Orthopaedic Surgery | 5130 Linton Blvd Ste B2, Delray Beach, FL 33484-6595 | 2018-06-19 |
| 1801318423 | Royal Palm Beach Rehab, Corp | Orthopaedic Surgery | 600 University Blvd Ste 104, Jupiter, FL 33458-2778 | 2017-07-14 |
| 1902255854 | Carlos Segovia | Orthopaedic Surgery | 17779 Sw 2nd Street, Pembroke Pines, FL 33029 | 2016-06-10 |
| 1437520509 | Timothy Joseeph Forness | Orthopaedic Surgery | 3802 Dogwood Ave, Palm Beach Gardens, FL 33410-4755 | 2015-10-14 |
| 1275927766 | Robert O'leary | Orthopaedic Surgery | 1150 Campo Sano Ave Fl 2, Coral Gables, FL 33146-1174 | 2015-03-24 |
| 1134548019 | Alexander David Gaukhman | Orthopaedic Surgery | 670 Glades Rd Ste 300, Boca Raton, FL 33431-6464 | 2014-04-08 |
| 1124379706 | Elvis Grandic Md Pa | Orthopaedic Surgery | 7744 Dawson Ct, Lake Worth, FL 33467-7719 | 2012-09-24 |
| 1104184951 | Thomas Jacob Seales | Orthopaedic Surgery | 2021 Nw 136th Ave Apt 284, Sunrise, FL 33323-5375 | 2012-04-30 |
| 1558629527 | Tri-county Orthopaedic Center, Pa | Orthopaedic Surgery | 765 Hwy 466, Lady Lake, FL 32159-6340 | 2012-04-27 |
| 1356636591 | Obinna Ogechukwu Adigweme | Orthopaedic Surgery | 2699 Lee Rd Ste 100, Winter Park, FL 32789 | 2011-06-16 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
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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.