PRESTIGE DERMATOLOGY INC (NPI# 1205039682) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205039682 |
| Entity Type | Organization |
| Organization Name | PRESTIGE DERMATOLOGY INC |
| Practice Address |
5091 Little Road New Port Richey FL 34655 |
| Practice Telephone | 7278491447 |
| Practice Fax Number | 7278493208 |
| Mailing Telephone | 7278491447 |
| Mailing Fax Number | 7278493208 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2019-10-01 |
| Authorized Official Name | NATALIE L MONTICCIOLO (PROVIDER) |
| Authorized Official Telephone | 7278491447 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | OS7718 | FL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4546 Grand Blvd, New Port Richey, FL 346525119 | 7278491447 | 7278493208 |
| Street Address |
5091 LITTLE ROAD |
| City | NEW PORT RICHEY |
| State | FL |
| Zip Code | 34655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376532895 | Natalie Lama Monticciolo | Specialist | 5091 Little Road, New Port Richey, FL 34653 | 2005-10-18 |
| 1972747699 | Allison Maritsa Lowie | Nurse Practitioner | 5091 Little Road, New Port Richey, FL 34655 | 2009-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245845221 | Kathryn E Wright | Social Worker | 8225 Florida State Road 54, New Port Richey, FL 34655 | 2020-09-15 |
| 1245873728 | Trinity Counseling Services | Marriage & Family Therapist | 1934 Duck Slough, Trinity, FL 34655 | 2019-10-28 |
| 1134770563 | Timothy Foster | Licensed Practical Nurse | 9332 Sr 54, Ste 202, Trinity, FL 34655 | 2019-09-26 |
| 1710542824 | Leah E. Grossman | Student in an Organized Health Care Education/Training Program | Medical Center of Trinity, 9330 State Rd 54, Trinity, FL 34655 | 2019-05-03 |
| 1508420696 | Varun Reddy | Student in an Organized Health Care Education/Training Program | 9330 Fl 54, Trinity, FL 34655 | 2019-04-24 |
| 1184183642 | Courtney Lynne Fagan | Specialist/Technologist | 8225 Fl-54, New Port Richey, FL 34655 | 2019-03-14 |
| 1164996633 | Brooke E Cox | Obstetrics & Gynecology | 8145 Cerebellum Way Ste 102, Trinity, FL 34655 | 2019-01-17 |
| 1144734591 | Optimal Performance and Physical Therapies Trinity LLC | Physical Therapist | 11157 Trinity Blvd, Trinity, FL 34655 | 2017-11-21 |
| 1629581285 | Nationwide Vision Center, LLC | Technician/Technologist | 3238 Little Rd, Trinity, FL 34655 | 2017-11-06 |
| 1053834267 | Spnn LLC | Pharmacy | 5429 Little Rd, New Port Richey, FL 34655 | 2017-07-19 |
| Find all providers in zip 34655 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417241332 | Candescent Prestige LLC | Dermatology | 4546 Grand Blvd, New Port Richey, FL 34652-5119 | 2011-06-08 |
| 1033238415 | Brian T. Johnson, Md, Pa | Dermatology | 5341 Grand Blvd Ste 102, New Port Richey, FL 34652-4011 | 2007-03-28 |
| 1245307453 | Aivlys Perez Polanco | Dermatology | 8209 State Road 54, New Port Richey, FL 34655-3016 | 2006-11-30 |
| 1952909467 | Sophia Gevoy | Dermatology | 8209 State Road 54, New Port Richey, FL 34655-3016 | 2020-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | NEW PORT RICHEY |
| Zip Code | 34655 |
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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.