COLEMAN J BRYAN JR. (NPI# 1962585968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962585968 |
| Entity Type | Individual |
| Full Name | COLEMAN J BRYAN JR. |
| Credential | M.D., MSPH |
| Practice Address |
554 Keily Street Jacksonville FL 32212 |
| Practice Telephone | 7579537550 |
| Practice Fax Number | 7579537560 |
| Mailing Telephone | 7579537550 |
| Mailing Fax Number | 7579537560 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2017-04-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
0101254561 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 009994025 | 05 | |
| AL | 009993995 | 05 |
| Street Address |
554 KEILY STREET |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326019373 | Brian G Norwood | Pediatrics | 554 Keily Street, Jacksonville, FL 32212 | 2006-01-29 |
| 1811461726 | Yocelin Hernandez Rojero | Occupational Therapist | 554 Keily Street, Jacksonville Fl 32212, Jacksonville, FL 32212 | 2019-01-14 |
| 1609381235 | Miranda Shilelagh Schmidt | Physician Assistant | 554 Keily Street, Jacksonville, FL 32212 | 2017-12-05 |
| 1144733627 | Tylisha Elyse Deshields | Social Worker | 554 Keily Street, Jacksonville, FL 32212 | 2017-11-07 |
| 1326557976 | David Michael Tatera | Psychologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-27 |
| 1104335348 | Kuang-hui Lee | General Practice | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-20 |
| 1548788177 | Sophia Renee Beal | Speech-Language Pathologist | 554 Keily Street, Jacksonville, FL 32212 | 2017-09-04 |
| 1164949418 | George S Bennitt | Dentist | 554 Keily Street, Jacksonville, FL 32212-4047 | 2017-08-28 |
| 1124545389 | David Phillips | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Centralized Credential and Privileging Directorate, Jacksonville, FL 32212-2466 | 2017-08-28 |
| 1902323652 | Erich Chen | Student in an Organized Health Care Education/Training Program | 554 Keily Street, Jacksonville, FL 32212 | 2017-08-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1518484427 | Amy Kathryn Lee | Student in an Organized Health Care Education/Training Program | Bumed, Centralized Credential & Privileging Directorate, 554 Keily Street, Jacksonville, FL 32212 | 2017-08-23 |
| 1659827970 | Noah Fixelle | Dentist | Bureau of Med and Surg Ccpd, 554 Keily Street, Jacksonville, VA 32212 | 2016-08-28 |
| 1972953339 | Colin Kenneth Kelly | General Practice | Bureau of Medicine & Surgery Detachment, Nas Jacksonville, Building 554, Jacksonville, FL 32212 | 2016-06-16 |
| 1912382359 | Caitlyn Brooke Hoysock | Dentist | 554 Keiley Street, Bureau of Medicine and Surgery - Credentials, Jacksonville, FL 32212 | 2015-07-28 |
| 1285017418 | John Alexander Ruch | Dentist | 554 Keily Street Bureau of Med and Surg Ccpd, Jacksonville, FL 32212 | 2015-07-07 |
| 1407238561 | Amanda Mona Lau | Student in an Organized Health Care Education/Training Program | 554 Kelly Street, Attn Centralized Credentialing, Bureau of Medicine and Surgery, Jacksonville, FL 32212 | 2015-06-25 |
| 1063894715 | Heather Dehaan | Family Medicine | 554 Kelly Street Bureau of Medicine and Surgery, Attention: Centralized Credentialing & Privileging Dire, Jacksonville, FL 32212 | 2015-06-18 |
| 1912389677 | Catherine Garcia | Student in an Organized Health Care Education/Training Program | 554 Kelly St, Credentialing & Privileging Directorate, Bureau of Medicine & Surgery, Attention: Centralized, Jacksonville, FL 32212 | 2015-06-18 |
| 1255712675 | James Robert Benson | Dentist | 734 Keily Street, Bumed, Jacksonville, FL 32212 | 2015-06-11 |
| Find all providers in zip 32212 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982073573 | Lauren Mobley | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2015-09-24 |
| 1245596303 | Allison Spencer Bechtel | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2012-04-03 |
| 1639258486 | Manisha Makker Bansal | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-11-03 |
| 1174614192 | Michael J. Joyce | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-09-27 |
| 1891886818 | Paul A. Pitel | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-09-27 |
| 1417048422 | Cynthia A. Gauger | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-09-27 |
| 1972514495 | Scott M. Bradfield | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-08-10 |
| 1316969512 | Howard M Katzenstein | Pediatrics | 807 Childrens Way, Jacksonville, FL 32207-8426 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225598626 | Kidz Medical Services, Inc. | Pediatrics | 3100 Sw 62 Ave Suite 121-north East Wing, Miami, FL 33155-3009 | 2019-03-21 |
| 1417429986 | Natalie Gallegos | Pediatrics | 3100 Sw 62nd Ave # 122, Miami, FL 33155-3009 | 2018-12-21 |
| 1679978118 | Baptist Health Medical Group Oncology LLC | Pediatrics | 8940 N. Kendall Dr, Ste. 300e, Miami, FL 33176 | 2014-10-27 |
| 1225465461 | Victor M Montes Jordan | Pediatrics | 710 Wickham Lakes Dr, Viera, FL 32940-2200 | 2013-10-02 |
| 1801138144 | Taumoha Ghosh | Pediatrics | 1601 Nw 12th Ave Fl 5, Miami, FL 33136-1005 | 2013-03-25 |
| 1508112731 | Muaz Alabd Alrazzak | Pediatrics | 9980 Central Park Blvd., Suite 206, Boca Raton, FL 33428-1703 | 2012-07-25 |
| 1194080382 | Jorge Ricardo Galvez Silva | Pediatrics | 3100 Sw 62nd Ave Ste 121, Miami, FL 33155-3009 | 2012-07-12 |
| 1609025915 | Maggie C. Fader | Pediatrics | 3100 Sw 62 Ave (#212, N.e. Wing), Miami, FL 33155 | 2008-09-10 |
| 1679791370 | Guillermo Roberto De Angulo | Pediatrics | 3100 Sw 62nd Avenue, Ne Wing, Suite 121, Miami, FL 33155 | 2007-04-20 |
| 1417094707 | Kelly Sawczyn | Pediatrics | 9981 S. Healthpark Drive, Suite 156, Fort Myers, FL 33908-3618 | 2007-01-30 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32212 |
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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.