SALTWATER FAMILY PRACTICE (NPI# 1952900953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952900953 |
| Entity Type | Organization |
| Organization Name | SALTWATER FAMILY PRACTICE |
| Practice Address |
305 Clyde Morris Blvd Ste 200 Ormond Beach FL 32174-8182 |
| Mailing Address |
156 Tuscany Bend St Daytona Beach FL 32117-5545 |
| Practice Telephone | 3862810939 |
| Mailing Telephone | 3862810939 |
| Enumeration Date | 2020-10-21 |
| Last Update Date | 2020-10-21 |
| Authorized Official Name | ANDREA LEE MERCADO (APRN) |
| Authorized Official Telephone | 3862810939 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
305 CLYDE MORRIS BLVD STE 200 |
| City | ORMOND BEACH |
| State | FL |
| Zip Code | 32174-8182 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467897868 | Avani Patel | Pharmacist | 305 Clyde Morris Blvd Ste 200, Ormond Beach, FL 32174-8182 | 2013-04-30 |
| 1073943197 | Sarju Group LLC | Pharmacy | 305 Clyde Morris Blvd Ste 200, Ormond Beach, FL 32174-8182 | 2013-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215574991 | Case Vision Pa | Optometrist | Eye Savers, 1474 W. Granada Blvd. #470, Ormond Beach, FL 32174 | 2019-12-02 |
| 1235797143 | Galia Leilani Medrano Ramirez | Dentist | 1274 W. Granada Blvd, Ormond Beach, FL 32174 | 2019-06-05 |
| 1295299220 | Jessica Johnson Hills | Nurse Practitioner | 1400 Hand Ave Ste K, Ormond Beach, FL 32174 | 2019-01-23 |
| 1437507043 | Natasha Jairam | Family Medicine | Adventhealth Medical Group Family Medicine, 400 Clyde Morris Blvd Ste A, Ormond Beach, FL 32174 | 2016-05-25 |
| 1871956540 | Lisa Anne Parissi | Chiropractor | 157 Kimberly Drive, Ormond Beach, FL 32174 | 2016-03-31 |
| 1023477940 | Ambassador Health Services, Inc | In Home Supportive Care | 136 N Orchard St Ste 1, Ormond Beach, FL 32174 | 2016-02-19 |
| 1619341518 | Maria Rogers | Optometrist | 9 Abacus Ave, Ormond Beach, FL 32174 | 2015-11-16 |
| 1285003830 | Sydney Kalin Neuhardt | Nurse Practitioner | 725 W. Granada Blvd. Ste 1, Ormond Beach, FL 32174 | 2015-09-24 |
| 1194107821 | Jerusha Thacker | Case Manager/Care Coordinator | 259 Bill France Blvd. Ste 200, Daytona Beach, FL 32174 | 2015-06-18 |
| 1730569971 | Daniel Joseph Lapolla | Physical Therapy Assistant | 1275 Granada Blvd, Suite 4b2, Ormond Beach, FL 32174 | 2015-06-03 |
| Find all providers in zip 32174 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831199710 | Coastal Pediatrics LLC | Clinic/Center | 1275 W Granada Blvd, Ste 3a, Ormond Beach, FL 32174-8259 | 2005-07-21 |
| 1740673425 | Pablo Garcia Jr Md | Clinic/Center | 290 Clyde Morris Blvd, Suite A-1, Ormond Beach, FL 32174-8130 | 2015-03-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174122337 | Life Line Medical Group Inc | Clinic/Center | 12595 Sw 137th Ave Ste 206, Miami, FL 33186-4221 | 2020-10-20 |
| 1558977926 | Ohi West Medical Group, LLC | Clinic/Center | 603 7th St S Ste 350, St Petersburg, FL 33701-4732 | 2020-09-21 |
| 1205441615 | Washington Hills Primary Care | Clinic/Center | 4645 Plantation Oaks Blvd, Orange Park, FL 32065-3652 | 2020-09-11 |
| 1699380329 | Premier Health System LLC | Clinic/Center | 12970 Sw 133rd Ct Ste A, Miami, FL 33186-5806 | 2020-09-10 |
| 1093328163 | Sunmed Group LLC | Clinic/Center | 2499 Glades Rd Ste 305a, Boca Raton, FL 33431-7202 | 2020-08-28 |
| 1790398246 | Emc 360, LLC | Clinic/Center | 1008 Juliette Blvd, Mount Dora, FL 32757-6500 | 2020-08-25 |
| 1720690704 | Celena Vinent Carbonell M.d., P.a. | Clinic/Center | 1001 N Macdill Ave Ste D, Tampa, FL 33607-5152 | 2020-08-20 |
| 1548871866 | 1st Call Primary Care, LLC | Clinic/Center | 955 S Woodland Blvd Ste A1, Deland, FL 32720-7321 | 2020-08-11 |
| 1912517152 | Curos Inc | Clinic/Center | 1425 Sw 8th Ct, Ft Lauderdale, FL 33312-7291 | 2020-08-03 |
| 1104436492 | Caretinuum Health | Clinic/Center | 3208 W Lake Mary Blvd Ste 1710, Lake Mary, FL 32746-3467 | 2020-08-03 |
| Find all providers with the same taxonomy | ||||
| City | ORMOND BEACH |
| Zip Code | 32174 |
Please comment or provide details below to improve the information on SALTWATER FAMILY PRACTICE.
| 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.