MATTHEW FULLER (NPI# 1750946950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1750946950 |
Entity Type | Individual |
Full Name | MATTHEW FULLER |
Practice Address |
111 Lucky Dr Ormond Beach FL 32176-6672 |
Practice Telephone | 3867959322 |
Mailing Telephone | 3867959322 |
Enumeration Date | 2019-05-03 |
Last Update Date | 2019-05-03 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YM0800X |
Counselor Specialization: Mental Health |
IMH18270 | FL | Behavioral Health & Social Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992156681 | Matthew Fuller | Student in an Organized Health Care Education/Training Program | 34 Eldor Dr, South Walpole, MA 02071-1020 | 2016-06-24 |
1629678404 | Matthew Alton Fuller | Pharmacist | 11328 S Jordan Gtwy, South Jordan, UT 84095-4112 | 2020-10-29 |
1043671431 | Matthew John Fuller | Chiropractor | 3727 Buchanan Street, 203, San Francisco, CA 95134 | 2016-03-11 |
1457793549 | Matthew David Fuller | Pharmacist | 270 Central Pkwy, Heath, OH 43056-1278 | 2013-07-18 |
1396060406 | Matthew Joseph Fuller | Emergency Medicine | University of Utah Hospital, Salt Lake City, UT 84132-0001 | 2010-03-31 |
1417039470 | Matthew A. Fuller | Pharmacist | 10000 Brecksville Rd, Pharmacy Service 119 (b), Brecksville, OH 44141-3204 | 2006-10-19 |
Street Address |
111 LUCKY DR |
City | ORMOND BEACH |
State | FL |
Zip Code | 32176-6672 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912488446 | Laura Kuftic | Massage Therapist | 496 Hollywood Street, None, Ormond Beach, FL 32176 | 2018-08-23 |
1154809846 | Thomas Dubrule | Technician, Pathology | 176 Ormwood Dr, Ormond Beach, FL 32176 | 2018-08-03 |
1326590316 | Rsc Ormond Beach Seaside LLC | Assisted Living Facility | 1050 Ocean Short Blvd, Ormond Beach, FL 32176 | 2016-10-26 |
1114270717 | Kristi L Lafreniere | Nurse Practitioner | 215 Ponce De Leon Drive, Ormond Bch, FL 32176 | 2012-10-19 |
1043589922 | Jocelyn Marie Mazelow | Pharmacist | 205 E Granada Blvd., Ormond Beach, FL 32176 | 2011-12-21 |
1437390630 | Neal Galen Henegar | Massage Therapist | 195 Coquina Court, Ormond Beach, FL 32176 | 2009-03-18 |
1669612602 | Margarita J. Vagnier | Occupational Therapy Assistant | 3 Briggs Drive, Ormond Beach, FL 32176 | 2009-03-04 |
1063676278 | Elaine C Murphy | Chore Provider | 129 Beau Rivage Drive, Ormond Beach, FL 32176 | 2008-07-16 |
1063575017 | Carol Lynn Learned | Chiropractor | 147 East Granada Blvd, Ormond Beach, FL 32176 | 2006-12-19 |
1730132044 | Charles Thomas Donaldson | Emergency Medicine | 7 Sea Oats Terraace, Ormond Beach, FL 32176 | 2006-05-18 |
Find all providers in zip 32176 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801439773 | Dorothy M Fahey | Counselor | 134 Laurie Dr, Ormond Beach, FL 32176-3216 | 2019-10-23 |
1407416050 | Bette Brock Rutan | Counselor | 19 Cypress Hollow Ln, Ormond Beach, FL 32174-3047 | 2019-06-17 |
1033677133 | Karen Marie Palpant | Counselor | 194 E Granada Blvd, Ormond Beach, FL 32176-6616 | 2019-03-07 |
1790256162 | Jeanne Esguerra | Counselor | 329 Mcintosh Rd, Ormond Beach, FL 32174-5518 | 2018-12-11 |
1639539208 | Margaret Dawn Billings | Counselor | 1848 Airport Rd, Ormond Beach, FL 32174-8719 | 2016-02-25 |
1528405883 | Karen A Smith | Counselor | 4 Buckingham Dr, Ormond Beach, FL 32176-2802 | 2013-05-28 |
1699015859 | Erin Tracy Williams | Counselor | 731 Santa Ana Ave, Ormond Beach, FL 32174-7461 | 2013-02-26 |
1760739551 | Sara T Keen | Counselor | 1362 N Us Highway 1, Suite 301, Ormond Beach, FL 32174-8902 | 2012-08-10 |
1114282209 | Arika Mclain | Counselor | 533 N Nova Rd Fl 32174, Ormond Beach, FL 32174-4447 | 2012-07-05 |
1063719821 | Rita Marino | Counselor | 1687 W Granada Blvd, Ormond Beach, FL 32174-6709 | 2011-02-14 |
Find all providers in ORMOND BEACH |
City | ORMOND BEACH |
Zip Code | 32176 |
Please comment or provide details below to improve the information on MATTHEW FULLER.
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.