Migun of the Beaches

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MIGUN OF THE BEACHES

Practice address

363 Atlantic Blvd Ste 12
Atlantic Beach, FL 32233-5283

Phone

(904) 242-0800

Fax

(904) 242-0800

NPI assigned

Dec 10, 2007

Last updated

Dec 10, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Barbara A. Fettig, BS

Title

President

Phone

(904) 242-0800

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1669655981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 ATLANTIC BLVD STE 12",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322335283",
            "telephone_number": "904-242-0800",
            "fax_number": "904-242-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 ATLANTIC BLVD STE 12",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322335283",
            "telephone_number": "904-242-0800",
            "fax_number": "904-242-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIGUN OF THE BEACHES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "FETTIG",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-242-0800",
        "authorized_official_credential": "BS"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derick McElveen Jr., PHARMD
• Medical Auto Transport LLC
• Medico Beaches LLC
• Memory Doc
• Mark Allen Messinese, MD
• Stephanie Mimms, OTR/L
• Matthew Modansky, M.D.
• Susan Elizabeth Mullins, OTR/L
• Jamie Mullis, CAA
• Amari Murel

• Durable Medical Equipment & Medical Supplies in Atlantic Beach, FL
• Providers in Atlantic Beach, FL by specialty
• Durable Medical Equipment & Medical Supplies in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.