INFORMEDDNA MEDICAL GROUP, P.A. (NPI# 1942842042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942842042 |
| Entity Type | Organization |
| Organization Name | INFORMEDDNA MEDICAL GROUP, P.A. |
| Practice Address |
877 Executive Center Drive West Suite 206 St. Petersburg FL 33702-5536 |
| Practice Telephone | 8009754819 |
| Practice Fax Number | 7602031194 |
| Mailing Telephone | 8009754819 |
| Mailing Fax Number | 7602031194 |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |
| Authorized Official Name | REBECCA SUTPHEN (PRESIDENT) |
| Authorized Official Telephone | 8009754819 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 170300000X | Genetic Counselor, MS | Other Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | InformedDNA Medical Group, P.A. | 877 Executive Center Drive W, Suite 306, Saint Petersburg, FL 33702 |
| New York State Corporations | INFORMEDDNA MEDICAL GROUP, P.A. | One Commerce Plaza, 99 Washington Ave., Ste 805-a, Albany, New York 12210-2822 |
| Connecticut Business Registrations | INFORMEDDNA MEDICAL GROUP, P.A. INC. | 877 Executive Center Drive, W., Suite 206, St. Petersburg, FL 33702 |
| Street Address |
877 EXECUTIVE CENTER DRIVE WEST SUITE 206 |
| City | ST. PETERSBURG |
| State | FL |
| Zip Code | 33702-5536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700419637 | Lea Diana Stemplewski | Occupational Therapist | 8950 Dr. Mlk Jr. St. North, Ste 190, St. Petersburg, FL 33702 | 2020-02-19 |
| 1366919557 | Svetlana Nagle | Nurse Practitioner | 10601 Gandy Blvd. N., 5305, St Petersburg, FL 33702 | 2018-10-25 |
| 1457835613 | Joseph Kirchmer | Physical Therapy Assistant | 7101 9th St N, St Petersburg, FL 33702 | 2018-09-23 |
| 1386135176 | Valencia Gibson | Behavior Technician | 8950 Doctor Martin Luther King Jr Street North, 190, Saint Petersburg, FL 33702 | 2018-05-29 |
| 1740778760 | Nicole S Kapr | Behavior Technician | 8950 Doctor Mlk Street North, 190, St. Petersburg, FL 33702 | 2018-04-25 |
| 1003316050 | Sonya Lesnefsky | Behavior Technician | 8950 Dr Mlk St N #190, Saint Petersburg, FL 33702 | 2018-02-16 |
| 1003315086 | Erin Nicole Rogers | Behavior Technician | 8950 Dr Mlk Jr St N, #190, St Petersburg, FL 33702 | 2018-02-06 |
| 1881192482 | Carrie Langbo | Genetic Counselor, MS | Informeddna, 877 Executive Center Drive W, Suite 206, St. Petersburg, FL 33702 | 2018-01-29 |
| 1891203485 | Healthy Lifestyles Tampa Bay LLC | Psychologist | 8479 Dr Martin Luther King Jr St N, St Petersburg, FL 33702 | 2018-01-17 |
| 1649787235 | Gurdeep Singh | Behavior Technician | 8950 Dr Mlk Street N, Suite 190, Saint Petersburg, FL 33702 | 2018-01-04 |
| Find all providers in zip 33702 | ||||
| Taxonomy Code | 170300000X |
| Grouping | Other Service Providers |
| Classification | Genetic Counselor, MS |
| A masters trained health care provider who collects and interprets genetic family histories; assesses the risk of disease occurrence or recurrence; identifies interventions to manage or ameliorate disease risk; educates about inheritance, testing, management, prevention, ethical issues, resources, and research; and counsels to promote informed choices and adaptation. Certification was established in 1993 by the American Board of Genetic Counseling and prior to that by the American Board of Medical Genetics. Requirements for experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: National Society of Genetic Counselors [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881192482 | Carrie Langbo | Genetic Counselor, MS | Informeddna, 877 Executive Center Drive W, Suite 206, St. Petersburg, FL 33702 | 2018-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437708872 | Marie Jeanjean | Genetic Counselor, MS | 1501 Nw 10th Avenue, Brb 334 (m860), Miami, FL 33136 | 2019-09-09 |
| 1093362386 | Rossiter & Cummaro Enterprize LLC | Genetic Counselor, MS | 4501 Nesmith Rd, Plant City, FL 33567-3955 | 2019-08-21 |
| 1881248995 | Jessica Marie Smith | Genetic Counselor, MS | 1301 Palm Ave Ste 7a004, Jacksonville, FL 32207-8432 | 2019-07-26 |
| 1184198343 | Samuel Martin | Genetic Counselor, MS | 18040 Via Bellamare Ln, Miromar Lakes, FL 33913-7606 | 2019-01-21 |
| 1568931657 | Deena Wadie Wahba | Genetic Counselor, MS | 3001 W Dr Martin Luther King Jr Blvd # Ms 3105, Tampa, FL 33607-6307 | 2018-11-19 |
| 1831666544 | Jill Elizabeth Hendrickson | Genetic Counselor, MS | 1505 Sw Archer Rd Fl 1, Gainesville, FL 32608-1134 | 2018-10-31 |
| 1669948097 | Eric Scott Traub | Genetic Counselor, MS | 1699 Sw 16th Avenue, Building A, Cms B2334, Gainesville, FL 32608 | 2018-10-24 |
| 1558857821 | Sarah Khan | Genetic Counselor, MS | 15255 Max Leggett Pkwy Ste 6000, Jacksonville, FL 32218-7278 | 2018-07-10 |
| 1386174423 | Maria Cristina Flanagan | Genetic Counselor, MS | 8900 N Kendall Dr Ste 2n611, Miami, FL 33176-2118 | 2017-06-12 |
| 1831549617 | Amanda Caceres | Genetic Counselor, MS | 3438 Lawton Rd Ste 200f, Orlando, FL 32803-2948 | 2016-06-13 |
| Find all providers with the same taxonomy | ||||
| City | ST. PETERSBURG |
| Zip Code | 33702 |
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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.