FORT MYERS DERMATOPATHOLOGY (NPI# 1083829337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083829337 |
| Entity Type | Organization |
| Organization Name | FORT MYERS DERMATOPATHOLOGY |
| Practice Address |
4901 Palm Beach Blvd Suite 12 Fort Myers FL 33905-3252 |
| Mailing Address |
8381 Riverwalk Park Blvd Suite 202 Fort Myers FL 33919-8760 |
| Practice Telephone | 2392740005 |
| Practice Fax Number | 2392784718 |
| Mailing Telephone | 2392740005 |
| Mailing Fax Number | 2392784718 |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MAZEN DAOUD (PRESIDENT) |
| Authorized Official Telephone | 2392740005 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831304500 | Fort Myers Dermatopathology | Dermatology | 9411 Fountain Medical Court, Suite 101, Bonita Springs, FL 34135 | 2007-05-14 |
| 1215142567 | Fort Myers Dermatopathology | Dermatology | 643 Cape Coral Pkwy E, Suite E, Cape Coral, FL 33904-8549 | 2007-05-11 |
| 1366657629 | Fort Myers Dermatopathology | Dermatology | 9250 Corkscrew Rd, Suite 5, Estero, FL 33928-3208 | 2007-05-11 |
| Street Address |
4901 PALM BEACH BLVD SUITE 12 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33905-3252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811476211 | Lisa Nicole Campbell | Nurse Practitioner | 2850 Via Campania St, Fort Myers, FL 33905 | 2018-08-07 |
| 1538670260 | Doctorguarin LLC | Clinic/Center | 3143 Antica St, Fort Myers, FL 33905 | 2017-10-20 |
| 1366828931 | Dawn Bradley Arnp Pllc | Nurse Practitioner | 3056 Champion Ring Rd, Ft Myers, FL 33905 | 2015-08-06 |
| 1720480551 | Yohana Pierre Villarroel | Licensed Practical Nurse | 2789 Ortiz Ave., Fort Myers, FL 33905 | 2014-09-24 |
| 1639592090 | Hamprenate Service | Case Manager/Care Coordinator | 2789 Oritz Avenue, Fort Myere, FL 33905 | 2014-01-21 |
| 1255688743 | Ronak B Patel | Pharmacist | 9365 Via Murano Ct, Fort Myers, FL 33905 | 2012-08-14 |
| 1477824852 | Joseph Francis Kusiak | Plastic Surgery | 3320 Shady Bend, Fort Myers, FL 33905 | 2012-01-18 |
| 1336447838 | Vicky Brooks | Nurse Practitioner | 8960 Colonial Center Dr Ste 300, Fort Myers, FL 33905 | 2011-03-08 |
| 1790898666 | Access Medical South, Lc | Durable Medical Equipment & Medical Supplies | 5701 Country Lakes Dr., Suite 20, Ft. Myers, FL 33905 | 2006-08-16 |
| 1780691600 | Arthur Lee Strauss | Social Worker | 6000 South Dixie Hwy, Suite B, West Palm Beach, FL 33905 | 2006-08-02 |
| Find all providers in zip 33905 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245220698 | Laertes A Manuelidis | Dermatology | 8381 Riverwalk Park Blvd, Suite 1, Fort Myers, FL 33919-8760 | 2005-10-26 |
| 1811950371 | Associates In Dermatology M D P L | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-04-07 |
| 1265495782 | Keith M Benbenisty | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-04-07 |
| 1780646174 | Stanley V Schwartz | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-04-03 |
| 1710948476 | Anthony F Fransway | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-03-31 |
| 1346201001 | Marvin S Porter | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-03-31 |
| 1831150507 | Kip C Cullimore | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-03-31 |
| 1043271737 | Shari L Skinner | Dermatology | 8381 Riverwalk Park Blvd, Suite 101, Fort Myers, FL 33919-8760 | 2006-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013579002 | Alicia Nunez | Dermatology | 1000 W Broadway St Ste 206, Oviedo, FL 32765-9262 | 2019-07-01 |
| 1477114197 | Leslie Z Rohaidy | Dermatology | 55 Se 6th St Apt 3101, Miami, FL 33131-2570 | 2019-06-24 |
| 1376029579 | Gulfshore Dermatology At Coralwood, Pa | Dermatology | 326 Del Prado Blvd N Ste 301, Cape Coral, FL 33909-2288 | 2018-07-11 |
| 1033639786 | Beautysmart Dermatology Clinic and Medical Spa LLC | Dermatology | 94 S Federal Hwy, Boca Raton, FL 33432-4825 | 2017-06-23 |
| 1215319793 | Orlando Skin Institute, LLC | Dermatology | 110 Pond Ct, Ste 301, Debary, FL 32713 | 2015-06-22 |
| 1336584960 | Devorah R Shagalov | Dermatology | 3850 Hollywood Blvd Ste 403, Hollywood, FL 33021-6746 | 2013-05-09 |
| 1871834606 | Geoffrey Michael Siegel | Dermatology | 478 Alamanda Dr, Hallandale Beach, FL 33009-6508 | 2013-03-04 |
| 1174852560 | Nautilus Health Care Group, LLC | Dermatology | 5220 Belfort Rd S, Ste 130, Jacksonville, FL 32256 | 2009-12-14 |
| 1447494885 | Matteo Taerri | Dermatology | 510 Howard Ct, Sarasota, FL 34236-5050 | 2009-04-29 |
| 1336319045 | Miloslava Mician Md Pa | Dermatology | 3619 W Waters Ave, Tampa, FL 33614-2783 | 2008-03-10 |
| Find all providers with the same taxonomy | ||||
| City | FORT MYERS |
| Zip Code | 33905 |
Please comment or provide details below to improve the information on FORT MYERS DERMATOPATHOLOGY.
| 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.