COASTAL SKIN SURGERY AND DERMATOLOGY, PL (NPI# 1114238193) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114238193 |
| Entity Type | Organization |
| Organization Name | COASTAL SKIN SURGERY AND DERMATOLOGY, PL |
| Practice Address |
12469 Emerald Coast Pkwy W Suite 101 Miramar Beach FL 32550-8305 |
| Practice Telephone | 8506543376 |
| Practice Fax Number | 8506543320 |
| Mailing Telephone | 8506543376 |
| Mailing Fax Number | 8506543320 |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2011-04-21 |
| Authorized Official Name | DAVID C ADAMS (OWNER, PRESIDENT) |
| Authorized Official Telephone | 8506543376 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
ME92098 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BCBSFL | 00175 | 01 |
| Street Address |
12469 EMERALD COAST PKWY W SUITE 101 |
| City | MIRAMAR BEACH |
| State | FL |
| Zip Code | 32550-8305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528042256 | David C Adams | Dermatology | 12469 Emerald Coast Pkwy W, Miramar Beach, FL 32550-8305 | 2005-12-06 |
| 1821244302 | Darla Brittany Hobbs | Physician Assistant | 12469 Emerald Coast Pkwy W, Suite 101, Miramar Beach, FL 32550-8305 | 2008-08-15 |
| 1548425812 | Nicholas George Papajohn | Dermatology | 12469 Emerald Coast Pkwy W, Suite 101, Miramar Beach, FL 32550-8305 | 2008-07-25 |
| 1801096268 | Katherine Marie Eberly | Physician Assistant | 12469 Emerald Coast Pkwy W, Suite 101, Miramar Beach, FL 32550-8305 | 2007-07-23 |
| 1063423036 | Karoline Casey Dempsey | Physician Assistant | 12469 Emerald Coast Pkwy W, Miramar Beach, FL 32550 | 2006-08-11 |
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|---|---|---|---|---|
| 1326652645 | S & R Dental Services, Inc. | Dentist | Carr. Int'l Zaragoza 445-1, Cd. Juarez, CHIHUAHUA 32550 | 2020-09-03 |
| 1801304746 | Dina Smith | Student in an Organized Health Care Education/Training Program | 12815 Highway 98, Suite 108, Miramar Beach, FL 32550 | 2018-01-12 |
| 1023484565 | The Hormone Restoration Center | Health Maintenance Organization | 12889 Hwy 98 W, Suite 107b, Miramar Beach, FL 32550 | 2015-08-19 |
| 1093051344 | Jason E Baker Dds LLC | Dentist | 77 South Shore Drive, Miramar Beach, FL 32550 | 2012-12-13 |
| 1801166210 | Yadhira A. Diaz | Dentist | Carr. Internacional Waterfill #500, Zaragoza, CHIHUAHUA 32550 | 2012-01-03 |
| 1427340355 | Asim S Ahmed | Internal Medicine | 7720 Us Highway 98 W Ste 110, Miramar Beach, FL 32550 | 2011-05-11 |
| 1922234160 | Ryan Winters | Physical Therapy Assistant | 7720 Highway 98, 220, Destin, FL 32550 | 2009-06-02 |
| 1619169133 | Jessica Marie Virtue | Specialist | 12815 Hwy 98 W, Suite 114, Destin, FL 32550 | 2007-08-17 |
| 1811100217 | Maria G Vazquez | Dentist | 445 Zaragoza, Juarez, MEXICO 32550 | 2007-05-08 |
| 1013137082 | Dental Waterfill Sc | Dentist | 445 Saborosa Ave, Sabarosa, CHIH 32550 | 2007-05-01 |
| Find all providers in zip 32550 | ||||
| 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 |
|---|---|---|---|---|
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
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| 1942855150 | International Dermatology Research, Inc. | Dermatology | 8370 W Flagler St Ste 200, Miami, FL 33144-2038 | 2019-08-05 |
| 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 |
| 1992095681 | Leavitt Medical Associates of Florida Inc | Dermatology | 3427 Mariner Blvd, Spring Hill, FL 34609-2463 | 2011-04-14 |
| Find all providers with the same taxonomy | ||||
| City | MIRAMAR BEACH |
| Zip Code | 32550 |
Please comment or provide details below to improve the information on COASTAL SKIN SURGERY AND DERMATOLOGY, PL.
| 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.