Beach Medical Specialist PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME88405 Issued in FL

Legal business name

BEACH MEDICAL SPECIALIST PA

Practice address

9860 Beach Blvd
Jacksonville, FL 32246-4704

Phone

(904) 200-2978

Fax

(904) 807-9114

NPI assigned

Jan 31, 2007

Organization subpart

No

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

Authorized official

Name

Alejandro Cabigting Dizon, MDNPI 1225057193

Title

President

Phone

(904) 200-2978

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CIABAA

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alejandro Cabigting Dizon, MD

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1225057193
  Medicare reassignment NPD Authorized official
• Antonette Francisco Arevalo, APRN

  • Nurse Practitioner
  • Jacksonville Beach, FL
  • NPI 1285242743
  Medicare reassignment NPD
• Tatiana Vasylievna Barsukova, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Jacksonville, FL
  • NPI 1093974057
  Medicare reassignment NPD
• Naji Nouneh, M.D.

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1699708222
  Medicare reassignment NPD
• Jean Serna, APRN

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1831876697
  Medicare reassignment NPD
• Analyn Tesoro-Ofiara, APRN

  • Family Nurse Practitioner
  • Atlantic Beach, FL
  • NPI 1225529761
  Medicare reassignment NPD
• Arianne Lacuesta Vitug, APRN

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1447021878
  Medicare reassignment NPD
• Jeffrey Ludan Vongjesda, M.S., APRN, FNP-C

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1003286824
  Medicare reassignment NPD
• Chinenye Ogechukwu Ezedike, MD

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1437319159

  FL

  Medicare reassignment NPD
• Ana Paola Adamski

  • Family Nurse Practitioner
  • Jacksonville, FL
  • NPI 1023881729
  NPD
• Meinrado L Pontejos, APRN

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1184209249
  NPD
• Liberty Liboon Dizon, M.D.

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1417026063
  NPD (past)

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709683200000",
    "number": "1720125479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9860 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464704",
            "telephone_number": "904-200-2978",
            "fax_number": "904-807-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9860 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322464704",
            "telephone_number": "904-200-2978",
            "fax_number": "904-807-9114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACH MEDICAL SPECIALIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A",
        "authorized_official_last_name": "DIZON",
        "authorized_official_first_name": "ALEJANDRO",
        "authorized_official_middle_name": "CABIGTING",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "904-200-2978",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME88405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272420100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Be Pampered Foot Spa 1, LLC
• Be the Change Therapeutic Services LLC
• Be Well Healing Arts, LLC
• Lisa Beabout, RN
• Beach Boulevard Chiropractic
• Beach Road Labs LLC
• Lynn Lashay Beach, CAPT / MC / USN
• Pamela Beach, APRN
• Kiara Beacham
• Beaches Behavioral Health LLC

• Internal Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.