| Stephan M Esser, MD | |
|
232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 | |
| (904) 634-0640 | |
| (904) 634-0203 |
| Full Name | Stephan M Esser |
|---|---|
| Gender | Male |
| Speciality | Family Medicine - Sports Medicine |
| Location | 232 Ponte Vedra Park Dr, Ponte Vedra Beach, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154596898 | NPI | - | NPPES |
| 007267700 | Medicaid | FL | |
| 12057 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 149124 (North Carolina) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | ME112692 (Florida) | Primary |
| Entity Name | Southeast Orthopedic Specialists Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629025820 PECOS PAC ID: 1456246974 Enrollment ID: O20040216000301 |
| Mailing Address | Practice Location Address |
|---|---|
| Stephan M Esser, MD 6500 Bowden Rd, Suite 103, Jacksonville, FL 32216-8070 Ph: (904) 634-0640 | Stephan M Esser, MD 232 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082-6600 Ph: (904) 634-0640 |
Dr. Jeremy Shawn Mirabile, M.D. ABPM-ADM, FASAM Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1030 A1a N, Ponte Vedra Beach, FL 32082 Phone: 904-551-1394 Fax: 888-770-4284 | |
Eric J Norenberg, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 228 Ponte Vedra Park Dr Ste 500, Ponte Vedra Beach, FL 32082 Phone: 904-273-1180 Fax: 904-273-6116 | |
Jacob Marvin Wolf, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 A1a N Ste 101, Ponte Vedra Beach, FL 32082 Phone: 904-273-6900 Fax: 904-390-7479 | |
Dr. Thomas Allen Tomlin, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 830 A1a N Ste 13-137, Ponte Vedra Beach, FL 32082 Phone: 904-608-1420 | |
Mrs. Jessica Marie Clark, APRN Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 41 Willow Falls Trl, Ponte Vedra Beach, FL 32081 Phone: 352-817-1452 | |
Katie Longo Cantrell, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 A1a N Ste 101, Ponte Vedra Beach, FL 32082 Phone: 904-273-6900 Fax: 904-390-7479 | |
Shalaka Ghate, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 520 A1a N Ste 1, Ponte Vedra Beach, FL 32082 Phone: 904-273-6900 Fax: 904-390-7479 |