Douglas Shine (NPI# 1992821201, PAC ID# 0244513323) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1992821201 |
| PAC ID by PECOS | 0244513323 |
| Professional Enrollment ID | I20170215002743 |
| Full Name | Douglas Shine |
| Organization Legal Name | REFRESH CANOPY COVE, INC |
| Address |
1100 S Ponce De Leon Blvd 1 Comprehensive Medpsych Systems St Augustine FL 32084-6013 |
| Phone Number | 9048247733 |
| Gender | M |
| Graduation Year | 1972 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 3779822119 |
| Number of Group Practice Members | 72 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1100 S Ponce De Leon Blvd, Suite 1, Saint Augustine, FL 32084-6013 | 9413630878 | COMPREHENSIVE MEDPSYCH SYSTEMS, INC. |
| 300 Kingsley Lake Dr, Saint Augustine, FL 32092-3037 | 9413630878 | COMPREHENSIVE MEDPSYCH SYSTEMS, INC. |
| 1090 S Tamiami Trl, Sarasota, FL 34236-9116 | 9413630878 | REFRESH CANOPY COVE, INC |
| 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 | 9048247733 | REFRESH CANOPY COVE, INC |
| Organization Legal Name | REFRESH CANOPY COVE, INC |
| Physicians | 67 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Dustin R Harrison | Psychiatry | Refresh Canopy Cove, Inc | 7540 Cipriano Ct, Suite B, Fairhope, AL 36532-3029 |
| Kayla Jane Davidson | Psychiatry | Refresh Canopy Cove, Inc | 5251 Emerson St, Comprehensive Medpsych, Jacksonville, FL 32207-4932 |
| Michael H Leblond | Psychologist, Clinical | Refresh Canopy Cove, Inc | 6320 Venture Dr, Suite 203, Lakewood Ranch, FL 34202-5132 |
| Justin M Simpson | Psychologist, Clinical | Refresh Canopy Cove, Inc | 1300 Marsh Landing Pkwy, Suite 112, Jacksonville Beach, FL 32250-2407 |
| Karola Thurman | Clinical Social Worker | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| Judi Mcinerney | Psychologist, Clinical | Refresh Canopy Cove, Inc | 13099 S Cleveland Ave, 300 Comprehensive Medpsych, Fort Myers, FL 33907-3835 |
| Angela Gibson | Clinical Social Worker | Refresh Canopy Cove, Inc | 1090 S Tamiami Trl, Sarasota, FL 34236-9116 |
| Dale G Simpson | Psychologist, Clinical | Refresh Canopy Cove, Inc | 871 Venetia Bay Blvd, Suite 310, Venice, FL 34285-8054 |
| Christine Holmes | Clinical Social Worker | Refresh Canopy Cove, Inc | 1110 Montlimar Dr, Suite 500, Mobile, AL 36609-1794 |
| Jacqueline D Boutrouille | Psychiatry | Refresh Canopy Cove, Inc | 7880 N University Dr, 303 Comprehensive Medpsych Systems, Tamarac, FL 33321-2124 |
| Street Address |
1100 S PONCE DE LEON BLVD 1 COMPREHENSIVE MEDPSYCH SYSTEMS |
| City | ST AUGUSTINE |
| State | FL |
| Zip | 32084-6013 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Karola Thurman | Clinical Social Worker | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| Justin Forrest Dement | Clinical Social Worker | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| David J Gross | Dermatology | 1100 S Ponce De Leon Blvd, Suite 3b, St Augustine, FL 32084-6013 | |
| Sabrina Caceres | Psychiatry | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| S Graham Kosch | Psychologist, Clinical | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| Janice Wilmoth | Psychologist, Clinical | Refresh Canopy Cove, Inc | 1100 S Ponce De Leon Blvd, 1 Comprehensive Medpsych Systems, St Augustine, FL 32084-6013 |
| Michael Joseph Amiel | Psychiatry | Comprehensive Medpsych Systems, Inc. | 1100 S Ponce De Leon Blvd, Suite 1, Saint Augustine, FL 32084-6013 |
| Chadd Eaglin | Psychiatry | Comprehensive Medpsych Systems, Inc. | 1100 S Ponce De Leon Blvd, Saint Augustine, FL 32084-6013 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brendan Maney Miner | Diagnostic Radiology | Radadvantage A Professional Corporation | 510 14th St, St Augustine, FL 32084-1507 |
| James A Berwick | Clinical Social Worker | 505 22nd St, Saint Augustine, FL 32084-1798 | |
| Thomas James Quigg | Chiropractic | 2 /2 May St, Saint Augustine, FL 32084-2126 | |
| Shannon J Coyle | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Gloria M Sierra | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Patricia L Barrozo | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Jacqueline A Seguin | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Kristy L Beams | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Shana Carey | Nurse Practitioner | Minute Clinic LLC | 2703 N Ponce De Leon Blvd, Saint Augustine, FL 32084-2603 |
| Paul L Martin | Psychologist, Clinical | 2200 N Ponce De Leon Blvd, Suite 3, St Augustine, FL 32084-2650 | |
| Find all physicians in zip 32084 | |||
| City | ST AUGUSTINE |
| Zip Code | 32084 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | ST AUGUSTINE + CLINICAL SOCIAL WORKER |
Please comment or provide details below to improve the information on Douglas Shine.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.