Jared John Wallen (NPI# 1144596974, PAC ID# 6608141536) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1144596974 |
| PAC ID by PECOS | 6608141536 |
| Professional Enrollment ID | I20171003006813 |
| Full Name | Jared John Wallen |
| Organization Legal Name | FLORIDA HOSPITAL PHYSICIAN GROUP INC |
| Address |
938 Oakfield Dr Brandon FL 33511-4950 |
| Phone Number | 8136157030 |
| Gender | M |
| Medical School | RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY |
| Graduation Year | 2012 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 2365679057 |
| Number of Group Practice Members | 270 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 100173 | FLORIDA HOSPITAL TAMPA |
| 100132 | SOUTH FLORIDA BAPTIST HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 938 Oakfield Dr, Brandon, FL 33511-4950 | 8136157030 | FLORIDA HOSPITAL PHYSICIAN GROUP INC |
| Organization Legal Name | FLORIDA HOSPITAL PHYSICIAN GROUP INC |
| Physicians | 268 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Clare Rinberger | Nurse Practitioner | Florida Hospital Physician Group Inc | 900 49th St N, St Petersburg, FL 33710-6625 |
| Jena Lindsey Repking | Nurse Practitioner | Florida Hospital Physician Group Inc | 1801 Gulf To Bay Blvd, Clearwater, FL 33765-3413 |
| Sarah Jacquoline Cannon | Nurse Practitioner | Florida Hospital Physician Group Inc | 1477 Main St, Dunedin, FL 34698-6243 |
| Ryan James Reed | Internal Medicine | Florida Hospital Physician Group Inc | 12470 Telecom Dr, Suite 100, Temple Terrace, FL 33637-0904 |
| Shelby Devinney | Physician Assistant | Florida Hospital Physician Group Inc | 1218 Millennium Pkwy, Brandon, FL 33511-3895 |
| Elisa Thompson | Family Medicine | Florida Hospital Physician Group Inc | 18923 State Rd, Suite 54, Lutz, FL 33558-5268 |
| Mia Isadora Loyola Fronteras | Endocrinology | Florida Hospital Physician Group Inc | 13901 Bruce B Downs Blvd, Tampa, FL 33613-3905 |
| Roxene S Riles | Nurse Practitioner | Florida Hospital Physician Group Inc | 6560 Ulmerton Rd, Largo, FL 33771-4940 |
| Joyce Moore | Nurse Practitioner | Florida Hospital Physician Group Inc | 3851 4th St N, St Petersburg, FL 33703-6114 |
| Sierra L Davis | Family Medicine | Florida Hospital Physician Group Inc | 11420 N 56th St, Temple Terrace, FL 33617-2237 |
| Street Address |
938 OAKFIELD DR |
| City | BRANDON |
| State | FL |
| Zip | 33511-4950 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Angelo M Fernandes | Gastroenterology | Florida Hospital Physician Group Inc | 938 Oakfield Dr, Brandon, FL 33511-4950 |
| Haane G Massarotti | Colorectal Surgery (proctology) | Florida Hospital Physician Group Inc | 938 Oakfield Dr, Brandon, FL 33511-4950 |
| Jessica King | Nurse Practitioner | Florida Hospital Physician Group Inc | 938 Oakfield Dr, Brandon, FL 33511-4950 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| In Soon Park | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Michael G Siegman | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Jeffrey Scott Mino | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Gopal Grandhige | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Richard G Picciocca Jr. | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Cristiano V Alpendre | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Donovan N Tapper | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Stephen Allen Jones | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Francisco H Itriago | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Paul Anthony Taiganides | General Surgery | Suncoast Surgical Associates P A | 519 Medical Oaks Dr, Brandon, FL 33511 |
| Find all physicians in zip 33511 | |||
| City | BRANDON |
| Zip Code | 33511 |
| Specialty | UROLOGY |
| City + Specialty | BRANDON + UROLOGY |
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| 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.