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PONTE VEDRA PLASTIC SURGERY, INC
NPI 1841461100
Specialist in Ponte Vedra Beach, FL

Active since March 14, 2008CLIA Certified · 2 labs
209 PONTE VEDRA PARK DR, PONTE VEDRA BEACH, FL 32082(904) 273-6200(904) 280-8013 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ponte Vedra Plastic Surgery, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PONTE VEDRA PLASTIC SURGERY, INC (NPI 1841461100) is a healthcare organization registered as a specialist in Ponte Vedra Beach, Florida and active in the NPI registry since March 2008. The organization holds 2 active CLIA laboratory certificates and lists Robin Solomon, Director, as its authorized official.

NPPES Registry Identity

NPI1841461100
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NamePONTE VEDRA PLASTIC SURGERY, INC
Location Address209 PONTE VEDRA PARK DRPonte Vedra Beach, FL 32082-6600
Mailing Address209 Ponte Vedra Park DrivePonte Vedra Beach, FL 32082 · (904) 273-6200 · Fax (904) 280-8013
Phone(904) 273-6200
Fax(904) 280-8013
Organization SubpartNo
Authorized OfficialRobin SolomonDirector · (904) 273-6200
Enumeration DateMarch 14, 2008
Last NPPES UpdateApril 25, 2024
NPPES CertifiedApril 25, 2024
✔ NPI 1841461100 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

209 PONTE VEDRA PARK DR, Ponte Vedra Beach, FL 32082
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Other Identifiers 1

OtherCC8991FL · Railroad Medicare/palmetto Gpa

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).Insurance ›

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2216567

Ponte Vedra Plastic Surgery · Ponte Vedra Beach, FL
Active · expires Mar 14, 2027
CLIA Number10D2216567
Laboratory TypePharmacy
Certificate Effective DateMarch 15, 2025
Certificate Expiration DateMarch 14, 2027
Laboratory DirectorErez Stetnberg
Laboratory Phone(904) 273-6200
Laboratory LocationPonte Vedra Plastic Surgery209 Ponte Vedra Park Drive, Ponte Vedra Beach, FL 32082
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 10D2140378

Ponte Vedra Plastic Surgery · Jacksonville, FL
Active · expires Nov 20, 2027
CLIA Number10D2140378
Laboratory TypeSurgery Facility
Certificate Effective DateNovember 21, 2025
Certificate Expiration DateNovember 20, 2027
Laboratory DirectorHollie Jo Hickman
Laboratory Phone(904) 273-6200
Laboratory LocationPonte Vedra Plastic Surgery11512 Lake Mead Ave Suites 511 - 514, Jacksonville, FL 32216
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRETT J. SNYDER M.D.
Plastic Surgery
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
MRS. CLAUDETTE NARCISA WALKER ARNP
Nurse Practitioner
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
MS. CONNIE ANN JONGEWAARD MSN, ARNP, FNP-BC
Nurse Practitioner (Family)
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
DR. ROBERT W. BURK III M.D.
Specialist
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
MRS. ASHLEY MICHAUX ARNP
Nurse Practitioner (Family)
209 PONTE VEDRA PARK DR
PONTE VEDRA, FL 32082
St. Johns County (904) 273-6200
SHARON ANGELA PRINCE
Nurse Practitioner (Family)
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
JENNIFER MARIE THURMAN OLIVIERI
Nurse Practitioner
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200
DR. CARRIE LYN CUMMINGS DNP
Nurse Practitioner
209 PONTE VEDRA PARK DR
PONTE VEDRA BEACH, FL 32082
St. Johns County (904) 273-6200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ponte Vedra Plastic Surgery, Inc's NPI number?

The NPI number for Ponte Vedra Plastic Surgery, Inc is 1841461100. It was assigned to this organization in the NPPES registry on March 14, 2008.

Where is Ponte Vedra Plastic Surgery, Inc located?

Ponte Vedra Plastic Surgery, Inc is located at 209 Ponte Vedra Park Dr, Ponte Vedra Beach, FL 32082. The listed phone number is (904) 273-6200.

What is Ponte Vedra Plastic Surgery, Inc's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Ponte Vedra Plastic Surgery, Inc hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Ponte Vedra Plastic Surgery, Inc accept?

Health plans from Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Ponte Vedra Plastic Surgery, Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ponte Vedra Plastic Surgery, Inc was last updated on April 25, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.