SOUTHEASTERN PLASTIC SURGERY, P.A.


Address: 2030 Fleischmann Rd, Tallahassee, FL 32308
Phone: 8502192000

SOUTHEASTERN PLASTIC SURGERY, P.A. (NPI# 1801989884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1801989884
Entity Type Organization
Organization Name SOUTHEASTERN PLASTIC SURGERY, P.A.
Other Organization Name SOUTHEASTERN PLASTIC SURGERY
Practice Address 2030 Fleischmann Rd
Tallahassee
FL 32308
Practice Telephone 8502192000
Practice Fax Number 8508772138
Mailing Telephone 8502192000
Mailing Fax Number 8508772138
Enumeration Date 2006-10-02
Last Update Date 2016-11-10
Authorized Official Name MR. BEN J KIRBO (SURGEON/OWNER)
Authorized Official Telephone 8502192000
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2086S0122X Surgery
Specialization: Plastic and Reconstructive Surgery
Allopathic & Osteopathic Physicians

Other Provider/Organization Names

Other Name Type Code
Southeastern Plastic Surgery Doing Business As Name - Organization

Office Location

Street Address 2030 FLEISCHMANN RD
City TALLAHASSEE
State FL
Zip Code 32308

Providers in the same location

NPI Name Taxonomy Address Enumeration
1467494526 Laurence Zalmon Rosenberg Plastic Surgery 2030 Fleischmann Rd, Southeastern Plastic Surgery, Tallahassee, FL 32308-4599 2006-06-12
1790256667 Shannon Elizabeth Moninger Nurse Practitioner 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2018-12-17
1942792635 Brittany Decastro Nurse Practitioner 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2018-05-30
1043579949 Nimble Anesthesia, LLC Nurse Anesthetist, Certified Registered 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2012-05-11
1811102494 Kristen Snyder Costa Physician Assistant 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2007-05-14
1043425309 Leo Christopher Derosier Surgery 2030 Fleischmann Rd, Tallahassee, FL 32308 2007-05-11
1033223367 Southeastern Outpatient Surgery Center LLC Clinic/Center 2030 Fleischmann Rd, Tallahassee, FL 32308 2006-08-17
1720096761 Ben J Kirbo Plastic Surgery 2030 Fleischmann Rd, Tallahassee, FL 32308 2006-08-04
1184650483 Lisa L. Umana Nurse Anesthetist, Certified Registered 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2006-06-25
1598700197 Patti Dirkse Pijut Nurse Anesthetist, Certified Registered 2030 Fleischmann Rd, Tallahassee, FL 32308-4599 2006-06-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1215588306 Jmc Tallahassee, LLC Preventive Medicine 1838 Jacliff Court, Tallahassee, FL 32308 2019-09-20
1972165108 Covenant Home Health Care, LLC Home Health 1921 Capital Circle Ne, Tallahassee, FL 32308 2019-07-09
1548735798 North Florida Rehab Solutions Hospitalist 1675 Riggins Road, Dr Steele Lancaster, Tallahassee, FL 32308 2018-10-03
1013491596 Injury and Rehab Centers of North Florida, LLC Neuromusculoskeletal Medicine & OMM 2268 Wednesday Street, Tallahassee, Florida, FL 32308 2018-09-20
1487133625 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 2634 Capital Circle Ne, Building C, Suite 156, Tallahassee, FL 32308 2018-08-08
1629566724 Total Health & Wellness Home Care, LLC Home Health 1325 Mahan Dr., Tallahassee, FL 32308 2018-04-25
1669979480 Beth North, Lcsw, LLC Social Worker 1325 Mahan Drive, Tallahassee, FL 32308 2018-04-09
1750885919 Robert E Ashmore Jr Md Obstetrics & Gynecology 2770 Capitol Medical Blvd, Suite 100, Tallahassee, FL 32308 2018-03-22
1225547243 William Michael Kunkle Physician Assistant 4004 Norton Ln, Suite 101, Tallahassee, FL 32308 2017-09-21
1235657834 Traci R Raybon Occupational Therapist 1924 Hidden Valley, Tallahassee, FL 32308 2017-09-03
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Taxonomy Information

Taxonomy Code 2086S0122X
Grouping Allopathic & Osteopathic Physicians
Classification Surgery
Specialization Plastic and Reconstructive Surgery

Taxonomy Definition

A surgeon who specializes in plastic and reconstructive surgery.
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1568025419 Reinventme, LLC Surgery 13696 N Us Highway 441 Ste 100, Lady Lake, FL 32159-6815 2019-04-17
1750854378 David Gerth Md Pa Surgery 4308 Alton Rd Ste 940, Miami Beach, FL 33140-4560 2019-01-07
1588165773 Deepak Naidu Md, Pa Surgery 201 E Kennedy Blvd Ste 410, Tampa, FL 33602-3641 2018-02-23
1194225599 Joseph Charles Gallagher Jr. Surgery 9201 Midnight Pass Rd, Sarasota, FL 34242-2921 2018-02-13
1043729569 Renee Gasgarth, M.d. P.a. Surgery 7300 Sw 62nd Pl Ste 200, South Miami, FL 33143-4800 2017-09-27
1184150625 Pamela Loftus Surgery 4454 Woodfield Blvd, Boca Raton, FL 33434-5310 2017-05-03
1356898324 Waters Edge Dermatology Global LLC Surgery 2601 S Kanner Highway, Stuart, FL 34994 2016-09-07
1629482096 Jill Swindell Surgery 1921 Waldemere St Ste 801, Sarasota, FL 34239-2913 2014-06-13
1205274784 Melanie L Aya-ay Md Plastic Surgery Pl Surgery 17523 N Dale Mabry Hwy, Lutz, FL 33548-4521 2013-06-06
1790123487 Jason Crespo Surgery 1250 Pine Ridge Rd Ste 101c, Naples, FL 34108-8913 2013-06-05
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Competitor

Search similar providers

City TALLAHASSEE
Zip Code 32308

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Dataset Information

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.

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