John R Istad PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

CH6232 Issued in FL

Legal business name

JOHN R ISTAD PA

Practice address

1105 SE Port St Lucie Blvd
Port Saint Lucie, FL 34952-5332

Phone

(772) 398-5400

Fax

(772) 398-6600

NPI assigned

Dec 20, 2010

Organization subpart

No

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

Authorized official

Name

John R Istad, DC

Title

Owner

Phone

(772) 398-5400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1292803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1720381452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525332",
            "telephone_number": "772-398-5400",
            "fax_number": "772-398-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 SE PORT ST LUCIE BLVD",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349525332",
            "telephone_number": "772-398-5400",
            "fax_number": "772-398-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN R ISTAD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-20",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "ISTAD",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-398-5400",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "CH6232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diann M Jimenez, MS
• Ravi Jitta, D.C
• JJ Manor Assisted Living, LLC
• JN Louis LLC
• Ricardo Joassaint
• Anthony John
• Chontel A Johnson McCallum, LMHC
• Austin Nyland Johnson
• Doris Johnson
• Jeffrey Norman Johnson, PA-C

• Medical Specialty Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; 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.