SOUTHEASTERN INTEGRATED MEDICAL PL (NPI# 1871573949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871573949 |
| Entity Type | Organization |
| Organization Name | SOUTHEASTERN INTEGRATED MEDICAL PL |
| Practice Address |
4343 W Newberry Rd Gainesville FL 32607-2817 |
| Mailing Address |
4881 Nw 8th Ave Suite 2 Gainesville FL 32605-4582 |
| Practice Telephone | 3522242200 |
| Practice Fax Number | 3522242484 |
| Mailing Telephone | 3525472373 |
| Mailing Fax Number | 3524161813 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | DANIEL M DUNCANSON (CHEIF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 3522242200 |
| Authorized Official Credential | M.D.,C.P.E. |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHEASTERN INTEGRATED MEDICAL PL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians | ||
| N | 207KI0005X |
Allergy & Immunology Specialization: Clinical & Laboratory Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
Allopathic & Osteopathic Physicians | ||
| N | 207RM1200X |
Internal Medicine Specialization: Magnetic Resonance Imaging (MRI) |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207U00000X | Nuclear Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 204D00000X | Neuromusculoskeletal Medicine & OMM | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 058586600 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255762928 | Southeastern Integrated Medical Pl | Physical Medicine & Rehabilitation | 3305 Sw 34th Cir, Suite 101, Ocala, FL 34474-6616 | 2013-12-06 |
| 1720419484 | Southeastern Integrated Medical Pl | Physical Medicine & Rehabilitation | 1315 Nw 21st Ave, Suite 2, Chiefland, FL 32626-1977 | 2013-12-06 |
| 1912146853 | Southeastern Integrated Medical Pl | Radiology | 3304 Sw 34th Cir, Ocala, FL 34474-3358 | 2009-02-17 |
| 1093970162 | Southeastern Integrated Medical Pl | Counselor | 4881 Nw 8th Ave, Suite 2, Gainesville, FL 32605-4582 | 2008-07-28 |
| Street Address |
4343 W NEWBERRY RD |
| City | GAINESVILLE |
| State | FL |
| Zip Code | 32607-2817 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285629980 | Michael B Rozboril | Internal Medicine | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2005-09-19 |
| 1134606577 | Samantha Delaney Paedae | Physical Therapist | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2018-07-27 |
| 1639668304 | Shane Fisher | Physical Therapist | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2018-05-08 |
| 1639680127 | Simedhealth LLC | Internal Medicine | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2017-10-24 |
| 1003357021 | Lucia Gwyn-williams | Massage Therapist | 4343 W Newberry Rd, Ste #4, Gainesville, FL 32607-2817 | 2017-03-09 |
| 1821533282 | Guillermo Sanchez | Massage Therapist | 4343 W Newberry Rd, Suite 4, Gainesville, FL 32607-2817 | 2016-12-21 |
| 1568906139 | Amber Pina | Specialist | 4343 W Newberry Rd, Ste. 4, Gainesville, FL 32607-2817 | 2016-12-15 |
| 1154872067 | Stephanie Watson | Massage Therapist | 4343 W Newberry Rd, Suite 4, Gainesville, FL 32607-2817 | 2016-10-17 |
| 1992170153 | James Rylak | Physical Therapist | 4343 W Newberry Rd, Suite 4, Gainesville, FL 32607-2817 | 2015-12-14 |
| 1073991931 | Michelle Green | Nurse Practitioner | 4343 W Newberry Rd, Gainesville, FL 32607-2817 | 2015-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790335917 | Jennifer Jay | Behavioral Analyst | 4020 Sw 21st Rd, Gainesville, FL 32607 | 2019-09-19 |
| 1184186942 | The Birth Center At Cwh | Clinic/Center | 4454 Nw 6th Place, Gainesville, FL 32607 | 2019-04-02 |
| 1356823371 | Wendy Gibbs | Marriage & Family Therapist | 200 Nw 75th Drive, Suite B, Gainesville, FL 32607 | 2018-09-06 |
| 1104314368 | Meghan Bowser | Student in an Organized Health Care Education/Training Program | Academic Health Center Room 408, 1600 Sw Archer Road, Gainesville, FL 32607 | 2018-04-24 |
| 1942707328 | Anne Marie Littell | Student in an Organized Health Care Education/Training Program | 1707 N. Main Street, Gainesville, FL 32607 | 2018-04-11 |
| 1609378173 | Jeremy Markoski | Behavior Technician | 2035 Sw 75th St Suite B, Gainesville, FL 32607 | 2018-03-01 |
| 1013428085 | Adaric Kelly | Student in an Organized Health Care Education/Training Program | 502 Sw 34th St Apt 8, Gainesville, FL 32607 | 2017-10-18 |
| 1215454830 | Whitney Kristine Schaff | Dentist | 6110 Nw 1st Pl, Gainesville, FL 32607 | 2017-08-24 |
| 1316476674 | Jason Amadio | Specialist/Technologist | 1000 Sw 62nd Blvd, Gainesville, FL 32607 | 2017-06-08 |
| 1245784552 | Traci Pettigrew | Acupuncturist | 4001 Newberry Rd A3, Gainesville, FL 32607 | 2016-08-04 |
| Find all providers in zip 32607 | ||||
| Taxonomy Code | 204D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neuromusculoskeletal Medicine & OMM |
| The Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician directs special attention to the neuromusculoskeletal system and its interaction with other body systems. Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine, and integrates each of these into the management of pediatric, adolescent, adult, and geriatric patients. |
| Notes: Source: American Osteopathic Association, 2017 [7/1/2017: added definition] - Additional Resources: American Osteopathic Board of Neuromusculoskeletal Medicine, 2017, http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376702183 | Erik Michael Schabert | Neuromusculoskeletal Medicine & OMM | 4408 Nw 36th Ave, Gainesville, FL 32606-7215 | 2008-06-06 |
| 1053526871 | Vijayamala Bondugula | Neuromusculoskeletal Medicine & OMM | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618503 | Pcn Health and Wellness, LLC | Neuromusculoskeletal Medicine & OMM | 2627 Ne 203rd St Ste 100a, Miami, FL 33180-1945 | 2020-08-07 |
| 1316412836 | Osteopathic Medical Arts Center of South Florida LLC | Neuromusculoskeletal Medicine & OMM | 3700 Washington St Ste 401, Hollywood, FL 33021-8249 | 2018-10-11 |
| 1013491596 | Injury and Rehab Centers of North Florida, LLC | Neuromusculoskeletal Medicine & OMM | 2268 Wednesday Street, Tallahassee, Florida, FL 32308 | 2018-09-20 |
| 1366974800 | Derek Christopher Murphy | Neuromusculoskeletal Medicine & OMM | 110 Alafaya Woods Blvd Ste C-2, Oviedo, FL 32765-4000 | 2017-04-03 |
| 1639538143 | Amy Joy Selwach | Neuromusculoskeletal Medicine & OMM | 870 N Cocoa Blvd Ste A, Cocoa, FL 32922-7588 | 2016-02-12 |
| 1053611251 | Roger R. Verno, D.c.p.a. | Neuromusculoskeletal Medicine & OMM | 2620 N Australian Ave Ste 100, West Palm Beach, FL 33407-5626 | 2010-10-22 |
| 1427374354 | Nabeel Kouka | Neuromusculoskeletal Medicine & OMM | 2999 Ne 191st St Ste 260, Aventura, FL 33180-4925 | 2010-04-16 |
| 1104059005 | New Directions of Central Florida, LLC | Neuromusculoskeletal Medicine & OMM | 9425 Se Highway 42, Summerfield, FL 34491-6405 | 2009-08-26 |
| 1134357957 | Ramon G Lugo-sanchez | Neuromusculoskeletal Medicine & OMM | 2724 Sw 120th Ter, Miramar, FL 33025-0762 | 2009-07-01 |
| 1366618522 | Dermagenesis Medspa, Inc. | Neuromusculoskeletal Medicine & OMM | 2700 Sw 194th Ter, Miramar, FL 33029-2483 | 2008-05-07 |
| Find all providers with the same taxonomy | ||||
| City | GAINESVILLE |
| Zip Code | 32607 |
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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.