GARY L STEVENSMDPA (NPI# 1083825491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083825491 |
| Entity Type | Organization |
| Organization Name | GARY L STEVENSMDPA |
| Other Organization Name | CENTRAL FLORIDA DERMATOLOGY SKIN CANCER CENTER |
| Practice Address |
475 E Central Ave Winter Haven FL 33880-3051 |
| Practice Telephone | 8632932147 |
| Practice Fax Number | 8632942767 |
| Mailing Telephone | 8632932147 |
| Mailing Fax Number | 8632942767 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2008-04-11 |
| Authorized Official Name | DR. GARY L STEVENS (PRESIDENT) |
| Authorized Official Telephone | 8632932147 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
ME75661 | FL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Central Florida Dermatology skin Cancer Center | Doing Business As Name - Organization |
| Street Address |
475 E CENTRAL AVE |
| City | WINTER HAVEN |
| State | FL |
| Zip Code | 33880-3051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396925335 | Kristine Hoverkamp | Nurse Practitioner | 475 E Central Ave, Winter Haven, FL 33880-3051 | 2007-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851896955 | Cheryl Gonzalez | Physical Therapy Assistant | 1601 6th Street Swe, Winter Haven, FL 33880 | 2018-03-29 |
| 1265950661 | Integrity Prosthetics and Orthotics | Prosthetic/Orthotic Supplier | 135 1st Street South, Winter Haven, FL 33880 | 2017-09-06 |
| 1912423427 | Stacy Lewis | Counselor | 1943 Ave E Sw, Winter Haven, FL 33880 | 2017-08-16 |
| 1497275952 | Kleine Pediatrics | Pediatrics | 375 E Central Avenue, Suite 391, Winter Haven, FL 33880 | 2017-06-26 |
| 1255851457 | Farah N Habib | Dentist | 375 E Central Ave, Suite 361, Winter Haven, FL 33880 | 2017-06-20 |
| 1356878086 | Congruent Hearts Companions | Home Health | 111 Ave R N.e., Winter, FL 33880 | 2017-05-12 |
| 1689033201 | Jason Acosta | General Practice | 111 Avenue A Se, Winter Haven, FL 33880 | 2016-02-11 |
| 1629440573 | National Vision, Inc. | Technician/Technologist | 341 & 343 Cypress Gardens Blvd, Winter Haven, FL 33880 | 2015-10-30 |
| 1518336825 | Nicole A. Domenech | General Practice | 950 First St. South, Winter Haven, FL 33880 | 2015-09-16 |
| 1447666417 | Lee Tramell Vickers | Pharmacist | 701 1st Street, Winter Haven, FL 33880 | 2014-07-10 |
| Find all providers in zip 33880 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205066404 | K Wade Foster Md Pa | Dermatology | 1450 6th St Se, Winter Haven, FL 33880 | 2009-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827577 | Onspot-fl LLC. | Dermatology | 16461 Domestic Ave, Fort Myers, FL 33912-6008 | 2020-10-08 |
| 1942855150 | International Dermatology Research, Inc. | Dermatology | 8370 W Flagler St Ste 200, Miami, FL 33144-2038 | 2019-08-05 |
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1437517802 | Total Vein and Skin LLC | Dermatology | 10383 Hagen Ranch Road, Ste 100, Boynton Beach, FL 33437-3732 | 2016-02-01 |
| 1861812851 | Anand Haryani | Dermatology | 8745 N Us Highway 1, Sebastian, FL 32958-7524 | 2014-04-17 |
| 1164841797 | Michael Montuno | Dermatology | 38135 Market Sq Ste 108, Zephyrhills, FL 33542-7505 | 2014-04-10 |
| 1861813719 | Hillcrest Dermatology and Plastic Surgery P.a. | Dermatology | 733 Highway 466, Lady Lake, FL 32159-6340 | 2013-12-19 |
| 1922355957 | Florida Medical Specialists | Dermatology | 4351 Cortez Rd W, Suite 101, Bradenton, FL 34210 | 2012-08-09 |
| 1619232501 | Alliant Dermatology Pa | Dermatology | 8620 E County Road 466, The Villages, FL 32162-3670 | 2012-07-07 |
| 1114218328 | Leavitt Medical Assocaittes of Florida Inc | Dermatology | 1426 E Bloomindale Ave, Valrico, FL 33596 | 2011-04-21 |
| Find all providers with the same taxonomy | ||||
| City | WINTER HAVEN |
| Zip Code | 33880 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.