DR. FERDINAND JOSEPH FORMOSO (NPI# 1801000161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801000161 |
| Entity Type | Individual |
| Full Name | DR. FERDINAND JOSEPH FORMOSO |
| Credential | D.O. |
| Practice Address |
11555 Central Pkwy Suite 304 Jacksonville FL 32224-2691 |
| Mailing Address |
7855 Argyle Forest Blvd Suite 101 Jacksonville FL 32244-5596 |
| Practice Telephone | 9042657755 |
| Practice Fax Number | 9042657754 |
| Mailing Telephone | 9042826331 |
| Mailing Fax Number | 9042824117 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2017-10-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P2900X |
Physical Medicine & Rehabilitation Specialization: Pain Medicine |
OS10067 | FL | Allopathic & Osteopathic Physicians |
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
OS10067 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 000307800 | 05 | |
| FL | BCBS | 52892 | 01 |
| FL | MEDICARE RAILROAD | P00656925 | 01 |
| Street Address |
11555 CENTRAL PKWY SUITE 304 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-2691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265426829 | Luis U Ramirez | Internal Medicine | 11555 Central Pkwy, Ste 200, Jacksonville, FL 32224-2691 | 2005-09-09 |
| 1760880165 | Lauren Timney | Psychologist | 11555 Central Pkwy, Suite 704, Jacksonville, FL 32224-2691 | 2014-12-17 |
| 1346565215 | Ashley L Horn | Nurse Practitioner | 11555 Central Pkwy, Suite 201, Jacksonville, FL 32224-2691 | 2010-04-02 |
| 1679897243 | Luis U Ramirez Md Pa | Internal Medicine | 11555 Central Pkwy, Ste 200, Jacksonville, FL 32224-2691 | 2010-03-25 |
| 1316273733 | Lisa Permenter | Nurse Practitioner | 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 | 2009-10-20 |
| 1740418243 | Charles Travis Greenley | Physician Assistant | 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 | 2009-06-24 |
| 1679716344 | Haitao Zhang | Internal Medicine | 11555 Central Pkwy, Suite 304, Jacksonville, FL 32224-2691 | 2009-04-10 |
| 1245425065 | Dima Nassour Nassour | Internal Medicine | 11555 Central Pkwy, Suite 204, Jacksonville, FL 32224-2691 | 2007-09-14 |
| 1326050105 | Jose P Vindas Cordero | Specialist | 11555 Central Pkwy, Suite 204, Jacksonville, FL 32224-2691 | 2006-08-12 |
| 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 | 2081P2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Pain Medicine |
| A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. A subspecialty certificate was approved by the ABMS in 1999. ACGME Accredited Residency Program Requirements: Proposal under development. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962565457 | Mark Charles Hofmann | Physical Medicine & Rehabilitation | 2968 Rainbow Rd, Jacksonville, FL 32217-2435 | 2006-12-18 |
| 1578669933 | Jawed Hussain | Physical Medicine & Rehabilitation | 4063 Salisbury Rd Ste 100, Jacksonville, FL 32216-6199 | 2006-09-15 |
| 1396792818 | Allevia Medical, LLC | Physical Medicine & Rehabilitation | 14482 Cherry Lake Dr E, Jacksonville, FL 32258-5178 | 2006-05-29 |
| 1427011741 | Frank R Collier Jr. | Physical Medicine & Rehabilitation | 2627 Riverside Ave Fl 3, Jacksonville, FL 32204-4712 | 2006-04-08 |
| 1467445403 | Bao Tien Pham | Physical Medicine & Rehabilitation | 6816 Southpoint Pkwy, Suite 302, Jacksonville, FL 32216-1700 | 2005-08-24 |
| 1790045623 | Kyle R Bovee | Physical Medicine & Rehabilitation | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2012-05-25 |
| 1932428380 | Monika Yogesh Patel | Physical Medicine & Rehabilitation | 655 W 8th St, Jacksonville, FL 32209-6511 | 2010-05-25 |
| 1124273529 | Sunshine Spine and Pain, Pa | Physical Medicine & Rehabilitation | 3 Shircliff Way, Suite 610, Jacksonville, FL 32204-4757 | 2008-11-26 |
| 1215118062 | Accmed Healthcare Systems Inc | Physical Medicine & Rehabilitation | 6816 Southpoint Pkwy, Suite 302, Jacksonville, FL 32216-1700 | 2007-11-21 |
| 1790704153 | Marc Edward Tafflin | Physical Medicine & Rehabilitation | 1820 Barrs St, Suite 601, Jacksonville, FL 32204-4742 | 2006-07-18 |
| Find all providers in JACKSONVILLE | ||||
| 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.