DEDICATED SENIOR MEDICAL CENTER CLEARWATER, LLC. (NPI# 1700310422) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700310422 |
| Entity Type | Organization |
| Organization Name | DEDICATED SENIOR MEDICAL CENTER CLEARWATER, LLC. |
| Practice Address |
855 S Highland Avenue Dedicated Senior Medical Center St. Clearwater, LLC. Clearwater FL 33756 |
| Mailing Address |
1395 Nw 167th Street Chen Medical Corporate Office Miami Gardens FL 33169 |
| Practice Telephone | 3058314761 |
| Mailing Telephone | 3058314761 |
| Mailing Fax Number | 3058314761 |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | GLADYS FERNANDEZ-CORTES (MANAGING DIRECTOR) |
| Authorized Official Telephone | 3054984034 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
855 S HIGHLAND AVENUE DEDICATED SENIOR MEDICAL CENTER ST. CLEARWATER, LLC. |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33756 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659998060 | Guidewell Emergency Medicine Doctors, LLC | Clinic/Center | 1603 Missouri Ave, Clearwater, FL 33756 | 2020-07-01 |
| 1578104527 | M.k. El-yousef, M.d. LLC | Psychiatry & Neurology | 1555 S. Ft Harrison Ave, Clearwater, FL 33756 | 2019-10-01 |
| 1124672670 | Kayla Marie Flook | Counselor | 1106 Druid Rd S Suite 201, Clearwater, FL 33756 | 2019-08-01 |
| 1285192989 | Amy Elizabeth Dickson | Social Worker | 1260 S Mlk Jr Ave Ste D, Clearwater, FL 33756 | 2019-03-12 |
| 1548789951 | J. Carson Woolwine O.d. Pllc. | Optometrist | 912 S. Missouri Ave., Clearwater, FL 33756 | 2017-09-18 |
| 1760912349 | Kelly Morrissey | Counselor | 1240 South Fort Harrison Ave., Clearwater, FL 33756 | 2017-06-15 |
| 1972033744 | Edward Lewis Smith | Audiologist-Hearing Aid Fitter | 820 S Fort Harrison, Clearwater, FL 33756 | 2017-06-14 |
| 1306268339 | Theresa Anne Ritz | Counselor | 1260 S Martin Luther King Jr Ave Ste D, Clearwater, FL 33756 | 2014-01-10 |
| 1649513276 | Kerry Eileen Reller | Family Medicine | 708 Druid Rd. E, Clearwater, FL 33756 | 2013-04-02 |
| 1316286057 | Stanley Eugene Rosewater | Family Medicine | 1217 Ewing Street, Clearwater, FL 33756 | 2013-01-31 |
| Find all providers in zip 33756 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902431158 | James Robert Cook Jr. | Specialist | 2481 Sunset Point Rd, Clearwater, FL 33765-1514 | 2020-03-09 |
| 1215475587 | Daureen Pruszynski | Specialist | 2753 Highway 580, Suite 205, Clearwater, FL 33761-3345 | 2017-02-07 |
| 1598149072 | Kevin Christopher Votta | Specialist | 13825 Icot Blvd, Suite 600, Clearwater, FL 33760-3712 | 2015-07-15 |
| 1508153958 | April Ann Cook | Specialist | 600 Lakeview Rd., Suite E, Clearwater, FL 33756 | 2011-07-06 |
| 1700196516 | David F Abbott Jr. | Specialist | 2225 Building 37 Apt 102, Clearwater, FL 33764 | 2010-10-14 |
| 1811219553 | Ruth Marie Schopper-hughes | Specialist | 1721 Carlisle St, Clearwater, FL 33755-2306 | 2010-02-23 |
| 1245566991 | Jesse Ira Palmer | Specialist | 1621 Gulf Blvd Apt 501, Clearwater, FL 33767-2905 | 2009-10-29 |
| 1841422441 | Crystal Bay Radiology Pa | Specialist | 2568 Sweetgum Way W, Clearwater, FL 33761-3922 | 2009-08-14 |
| 1689808560 | Merle Annette Mullin | Specialist | 2401 Harn Blvd, Clearwater, FL 33764 | 2009-05-07 |
| 1558507772 | Charlene A Portman | Specialist | 754 N Belcher Rd, Clearwater, FL 33765-2138 | 2008-12-17 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33756 |
Please comment or provide details below to improve the information on DEDICATED SENIOR MEDICAL CENTER CLEARWATER, LLC..
| 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.