MRS. LOGAN M RETTEW (NPI# 1972977908) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972977908 |
| Entity Type | Individual |
| Full Name | MRS. LOGAN M RETTEW |
| Practice Address |
1211 Heidi Ln S Lakeland FL 33813-2321 |
| Practice Telephone | 7272512044 |
| Mailing Telephone | 7272512044 |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2016-02-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 367H00000X | Anesthesiologist Assistant | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | LICENSE | AA320 | 01 |
| Street Address |
1211 HEIDI LN S |
| City | LAKELAND |
| State | FL |
| Zip Code | 33813-2321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427600030 | Genesis Vieyra Lopez | Nurse Practitioner | 631 Mid Florida Drive, Lakeland, FL 33813 | 2019-07-13 |
| 1306323340 | Sandrene Smart | Clinic/Center | 625 Commerce Dr. (suite 103), Lakeland, FL 33813 | 2018-07-23 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1417317389 | Eye Specialists of Mid-florida, Pa | Ophthalmology | 2004 Cr 540 A, Lakeland, FL 33813 | 2016-03-04 |
| 1609234905 | Care and Life LLC | In Home Supportive Care | 6526 Fox Tree Lane, Lakeland, FL 33813 | 2016-02-02 |
| 1558731158 | Lori Ann Smith | Nurse Practitioner | 6030 S. Florida Ave, Suite 110, Lakeland, FL 33813 | 2015-09-25 |
| 1891182143 | Advanced Integrated Care Organization, LLC | Health Maintenance Organization | 5423 S. Florida Ave, Lakeland, FL 33813 | 2015-04-23 |
| 1902292352 | Central Health Associates | Internal Medicine | 4925 Old Rd 37, Lakeland, FL 33813 | 2015-04-13 |
| 1134542848 | Gledia Lovering | Dietitian, Registered | 6420 Highlands In The Woods St, Lakeland, FL 33813 | 2014-01-31 |
| 1134556368 | Billy Rogers | Nurse Anesthetist, Certified Registered | 4513 Orangewood Loop W., Lakeland, FL 33813 | 2013-10-02 |
| Find all providers in zip 33813 | ||||
| Taxonomy Code | 367H00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Anesthesiologist Assistant |
| An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437761798 | Wayleniz Rosario Falero | Anesthesiologist Assistant | 331 Sw 19th Ln, Cape Coral, FL 33991-3784 | 2020-08-18 |
| 1467062943 | George Pappas | Anesthesiologist Assistant | 1775 W. Hibiscus Blvd., Ste 215, Melbourne, FL 32901 | 2020-08-09 |
| 1821616228 | Katherine Tchir | Anesthesiologist Assistant | 851 Trafalgar Court Suite 200e, Maitland, FL 32751 | 2020-07-12 |
| 1992327308 | Daniel Le Phan | Anesthesiologist Assistant | 800 Prudential Dr Fl 32207, Jacksonville, FL 32207-8202 | 2020-05-08 |
| 1497395412 | Charles Joshua Thrower | Anesthesiologist Assistant | 1 Shircliff Way # Wat, Jacksonville, FL 32204-4748 | 2020-01-07 |
| 1194372227 | Matthew Zachary Laribee | Anesthesiologist Assistant | 7900 N Kendall Dr, Miami, FL 33156-7457 | 2019-08-22 |
| 1659856862 | Ian Michael Durham | Anesthesiologist Assistant | 1 Shircliff Way Fl 32204, Jacksonville, FL 32204-4748 | 2018-10-03 |
| 1386138287 | Stephen Johnson | Anesthesiologist Assistant | 157 Dawn Lauren Ln, Tallahassee, FL 32301-3415 | 2018-06-15 |
| 1164910691 | Heather Berman | Anesthesiologist Assistant | 209 Bristol Ct, Tavernier, FL 33070-2838 | 2018-04-30 |
| 1710437561 | Alyssa Scheidecker | Anesthesiologist Assistant | 12305 Hawthorne View Court, Tampa, FL 33626 | 2016-10-05 |
| Find all providers with the same taxonomy | ||||
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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.