Active NPI
Fleming Island Plastic Surgery LLC
- Plastic Surgery Physician
- Fleming Island, FL
National Provider Identifier
1497128953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- ME107749
- Legal business name
- FLEMING ISLAND PLASTIC SURGERY LLC
- Practice address
- 1679 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4815 - Phone
- (904) 348-0727
- NPI assigned
- Nov 5, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Shannon Delp
- Title
- Delegated Official
- Phone
- (904) 874-7215
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | ME107749 | FL | Primary |
Addresses
Primary practice location
1679 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4815
Mailing address
1679 Eagle Harbor Pkwy
Suite C
Fleming Island, FL 32003-4815
National Provider Directory
National Provider Directory- Tax ID family
- Fleming Island Plastic Surgery LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Plastic and Reconstructive Surgery Physician
- Fleming Island, FL
- NPI 1245602069
Locations
1679 Eagle Harbor Pkwy
Ste C
Orange Park, FL 32003
Phone (904) 348-0727
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic and Reconstructive Surgery Physician
- Fleming Island, FL
- NPI 1184842627
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1446681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1446681600000",
"number": "1497128953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1679 EAGLE HARBOR PKWY",
"address_2": "SUITE C",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320034815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1679 EAGLE HARBOR PKWY",
"address_2": "SUITE C",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "320034815",
"telephone_number": "904-348-0727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FLEMING ISLAND PLASTIC SURGERY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-11-05",
"last_updated": "2015-11-05",
"status": "A",
"authorized_official_last_name": "DELP",
"authorized_official_first_name": "SHANNON",
"authorized_official_title_or_position": "DELEGATED OFFICIAL",
"authorized_official_telephone_number": "904-874-7215"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": "FL",
"license": "ME107749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fleming Island, FL
- First Coast Speech & Language Services, LLC
- First Primary Care & Family Medicine Inc (Digiexpress Imaging)
- First Primary Care and Family Medicine, Inc. (DigiExpress Imaging)
- Fleming Island Pharmacy LLC (Fleming Island Pharmacy)
- Fleming Island Plastic Surgery LLC
- Fleming Island Vision Center, Inc. (Pearle Vision of Fleming Island)
- Florida Cancer Specialists & Research Institute, LLC (Florida Cancer Specialists)
- Florida Department of Health
- Florida Physician Specialists LLC (Advanced Prostate Cancer Institute)
- Florida Woman Care, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.