FORT MYERS DERMATOPATHOLOGY (NPI# 1215142567) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215142567 |
| Entity Type | Organization |
| Organization Name | FORT MYERS DERMATOPATHOLOGY |
| Practice Address |
643 Cape Coral Pkwy E Suite E Cape Coral FL 33904-8549 |
| Mailing Address |
8381 Riverwalk Park Blvd Suite 202 Fort Myers FL 33919-8760 |
| Practice Telephone | 2395490837 |
| Practice Fax Number | 2395498766 |
| 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 |
| 1083829337 | Fort Myers Dermatopathology | Dermatology | 4901 Palm Beach Blvd, Suite 12, Fort Myers, FL 33905-3252 | 2007-05-11 |
| 1366657629 | Fort Myers Dermatopathology | Dermatology | 9250 Corkscrew Rd, Suite 5, Estero, FL 33928-3208 | 2007-05-11 |
| Street Address |
643 CAPE CORAL PKWY E SUITE E |
| City | CAPE CORAL |
| State | FL |
| Zip Code | 33904-8549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063458404 | Michael Newton Price | Podiatrist | 643 Cape Coral Pkwy E, Ste. D, Cape Coral, FL 33904-8549 | 2006-06-22 |
| 1639770738 | Cape Harbor Chiropractic & Wellness | Chiropractor | 643 Cape Coral Pkwy E, Cape Coral, FL 33904-8549 | 2020-11-04 |
| 1225653819 | Kara C Graydon | Nurse Practitioner | 643 Cape Coral Pkwy E, Cape Coral, FL 33904-8549 | 2020-06-10 |
| 1568815934 | Tia Irminger | Nurse Practitioner | 643 Cape Coral Pkwy E, Cape Coral, FL 33904-8549 | 2016-07-20 |
| 1023288354 | Eric D. Rosenkrantz M.d. Pa | Internal Medicine | 643 Cape Coral Pkwy E, Suite F, Cape Coral, FL 33904-8549 | 2008-03-03 |
| 1821283706 | David R Driesbach Do | Family Medicine | 643 Cape Coral Pkwy E, Suite F, Cape Coral, FL 33904-8549 | 2007-09-13 |
| 1528126984 | Gregg F Mcneal | Dentist | 643 Cape Coral Pkwy E, #a, Cape Coral, FL 33904-8549 | 2006-12-05 |
| 1669574893 | Niccos John David | Podiatrist | 643 Cape Coral Pkwy E, Sutie D, Cape Coral, FL 33904-8549 | 2006-09-01 |
| 1760405468 | David R Driesbach | Family Medicine | 643 Cape Coral Pkwy E, Suite F, Cape Coral, FL 33904-8549 | 2006-07-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356835698 | Wendy Reyes Perez | Behavioral Analyst | 326 Se 31st St, Cape Coral, FL 33904 | 2018-06-20 |
| 1669923488 | Tcm Quality Services, Inc | Case Management | 2804 Del Prado Blvd, # 209 Suite 3, Cape Coral, FL 33904 | 2016-10-17 |
| 1851766471 | Malissa Maki | Social Worker | 3723a Delprado Blvd, Cape Coral, FL 33904 | 2015-12-08 |
| 1942688767 | Physicians Services and Rehab Inc | Physical Medicine & Rehabilitation | 506 Se 47th Terr Suite B, Cape Coral, FL 33904 | 2015-05-13 |
| 1790184356 | Rx Imaging of Swfl, LLC | Family Medicine | 506 Se 47th St Suite A, Cape Coral, FL 33904 | 2014-08-20 |
| 1508205634 | Brandy Williams | Counselor | 3723 A Del Prado Blvd S, Cape Coral, FL 33904 | 2013-06-21 |
| 1295002608 | Jcs Home Health, Inc. | Home Health | 1505 Se 40th St., Ste. C, Cape Coral, FL 33904 | 2011-11-30 |
| 1477835551 | Thomas Dare | Occupational Therapist | 4129 Se 2nd Ave., Cape Coral, FL 33904 | 2011-09-14 |
| 1134422173 | Michelle L Mandich | Massage Therapist | 3636 Del Prado Blvd S., Cape Coral, FL 33904 | 2010-12-14 |
| 1770807059 | Professional Nurses Registry | Nursing Care | 875 Se 47th Terr., Suite 1, Cape Coral, FL 33904 | 2010-03-16 |
| Find all providers in zip 33904 | ||||
| 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 |
|---|---|---|---|---|
| 1376029579 | Gulfshore Dermatology At Coralwood, Pa | Dermatology | 326 Del Prado Blvd N Ste 301, Cape Coral, FL 33909-2288 | 2018-07-11 |
| 1033315858 | Fred T Creech Md Pa | Dermatology | 304 Del Prado Blvd S Ste C, Cape Coral, FL 33990-5704 | 2007-06-27 |
| 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 |
| 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 |
| 1780852202 | Michael J. Rogers Md | Dermatology | 727 Us 27 S, Sebring, FL 33870-2169 | 2008-02-19 |
| Find all providers with the same taxonomy | ||||
| City | CAPE CORAL |
| Zip Code | 33904 |
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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.