ORLANDO SKIN INSTITUTE, LLC (NPI# 1215319793) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215319793 |
| Entity Type | Organization |
| Organization Name | ORLANDO SKIN INSTITUTE, LLC |
| Practice Address |
110 Pond Ct Ste 301 Debary FL 32713 |
| Practice Telephone | 3867420419 |
| Practice Fax Number | 3867424119 |
| Mailing Telephone | 3867420419 |
| Mailing Fax Number | 3867424119 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2015-06-22 |
| Authorized Official Name | GARY WATERMAN (OWNER) |
| Authorized Official Telephone | 3867420419 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
OS4781 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
110 POND CT STE 301 |
| City | DEBARY |
| State | FL |
| Zip Code | 32713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942668009 | Podiatry Plus, LLC | Podiatrist | 110 Pond Ct, Suite 102, Debary, FL 32713-2709 | 2016-02-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162766 | Jessica Crystal Daigle | Nurse Practitioner | 620 Spring Vista Dr, Ste 101, Debary, FL 32713 | 2020-07-23 |
| 1407320476 | 1st Call Urgent Care | Emergency Medicine | 173 North C.r. Beall Blvd., Suite 106, Debbary, FL 32713 | 2019-01-14 |
| 1073029294 | Ryan Patrick Mcneel | Chiropractor | 100 Pond Court, #103, Debary, FL 32713 | 2017-12-26 |
| 1528589249 | Jennifer Ellen Schaich | Technician, Pathology | 223 Bayou Vista St, Debary, FL 32713 | 2017-07-03 |
| 1083090807 | Home Modification Design, LLC | Home Health | 17 Pleasant Hill Drive, Debary, FL 32713 | 2015-08-04 |
| 1811255680 | Dana Louise Cannon | Massage Therapist | 17 Canter Club Court, Debary, FL 32713 | 2012-04-30 |
| 1811265127 | Orly Tyrkala | Pharmacist | 15 N Highway 1792, Debary, FL 32713 | 2011-12-01 |
| 1225331226 | Teresa Miller | Massage Therapist | 430 Summerhaven Drive, 300, Debary, FL 32713 | 2010-12-13 |
| 1043522857 | Amanda Ellen Lang | Behavioral Analyst | 454 Fort Florida Rd, Debary, FL 32713 | 2010-07-08 |
| 1437396470 | Keith Armando Jones | Occupational Therapist | 127 Pine Valley Court, Debary, FL 32713 | 2009-01-13 |
| Find all providers in zip 32713 | ||||
| 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 |
|---|---|---|---|---|
| 1982632527 | Gary L Waterman | Dermatology | 110 Pond Court, Suite 301, Debary, FL 32713 | 2006-06-30 |
| 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 |
| 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 | ||||
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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.