KATHLEEN ELIZABETH BROCKWAY (NPI# 1720227465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720227465 |
| Entity Type | Individual |
| Full Name | KATHLEEN ELIZABETH BROCKWAY |
| Practice Address |
13740 Beach Blvd Ste 404 Jacksonville FL 32224-6036 |
| Practice Telephone | 9042235595 |
| Practice Fax Number | 9042235594 |
| Mailing Telephone | 9042235595 |
| Mailing Fax Number | 9042235594 |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2009-02-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | Suppliers |
| Street Address |
13740 BEACH BLVD STE 404 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-6036 |
| 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 | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295367837 | Cranial Technologies, Inc. | Prosthetic/Orthotic Supplier | 1300 Riverplace Blvd Ste 100, Jacksonville, FL 32207-1815 | 2020-02-11 |
| 1952955627 | B Jazzy Salon Inc | Prosthetic/Orthotic Supplier | 5116 Gate Pkwy Apt 5111, Jacksonville, FL 32256-0265 | 2019-07-30 |
| 1043771777 | Jimetra West | Prosthetic/Orthotic Supplier | 1449 Morgana Rd, Jacksonville, FL 32211-4910 | 2019-03-26 |
| 1144769092 | Nupath Medical LLC | Prosthetic/Orthotic Supplier | 11244 Turnbridge Dr, Jacksonville, FL 32256-2342 | 2017-02-13 |
| 1700287018 | Janet Johnson | Prosthetic/Orthotic Supplier | 3132 Beach Blvd, Jacksonville, FL 32207-3710 | 2014-09-07 |
| 1043619166 | Nordstrom Inc & Subsidiaries | Prosthetic/Orthotic Supplier | 4835 Town Crossing Drive, Jacksonville, FL 32246-8577 | 2014-08-14 |
| 1053679365 | Jean T. Proulx | Prosthetic/Orthotic Supplier | 3132 Beach Boulevard, Jacksonville, FL 32207-3710 | 2012-04-25 |
| 1023309572 | Bremer Brace of Florida, Inc. | Prosthetic/Orthotic Supplier | 4131 University Blvd S Ste 16, Jacksonville, FL 32216-4346 | 2011-05-02 |
| 1760637599 | Brandis Wig Salon | Prosthetic/Orthotic Supplier | 7275 103rd St, Jacksonville, FL 32210 | 2008-11-20 |
| 1770778193 | Adaptive Technologies, LLC | Prosthetic/Orthotic Supplier | 2680 Henderson Drive, Suite 314, Jacksonville, NC 28546 | 2007-09-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32224 |
Please comment or provide details below to improve the information on KATHLEEN ELIZABETH BROCKWAY.
| 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.