FLORIDA DERMATOLOGY PLASTIC SURGERY LLC (NPI# 1295278943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295278943 |
| Entity Type | Organization |
| Organization Name | FLORIDA DERMATOLOGY PLASTIC SURGERY LLC |
| Practice Address |
6559 N Wickham Rd Suite 105 Melbourne FL 32940-2039 |
| Mailing Address |
Po Box 628721 Orlando FL 32862-8721 |
| Practice Telephone | 3213450552 |
| Mailing Telephone | 3212411160 |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2020-06-02 |
| Authorized Official Name | ANITA SALUJA (MANAGER) |
| Authorized Official Telephone | 3219173067 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208200000X | Plastic Surgery | ME118444 | FL | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | M82777 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
6559 N WICKHAM RD SUITE 105 |
| City | MELBOURNE |
| State | FL |
| Zip Code | 32940-2039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700403649 | True Motion Physical Therapy and Wellness | Clinic/Center | 3536 Peninsula Circle, Mlebourne, FL 32940 | 2020-06-26 |
| 1568089431 | Live Gracefully Physio and Wellness, Pllc | Clinic/Center | 6470 Shadow Creek Trail, Apt 5204, Melbourne, FL 32940 | 2020-06-26 |
| 1295360592 | Hiteshi Patel | Pharmacist | 3134 Hummingbird Way, Melbourne, FL 32940 | 2020-03-06 |
| 1972133122 | Curtis Lynn Curbo | Social Worker | 3830 Fringetree Lane, Melbourne, FL 32940 | 2020-01-16 |
| 1861038283 | Medfast Urgent Care Centers, LLC | Clinic/Center | 5500 Stadium Parkway, Melbourne, FL 32940 | 2019-11-20 |
| 1134601594 | Caroline Grace Bennett | Behavior Technician | 5500 Murrell Rd Suite 100, Melbourne, FL 32940 | 2018-09-02 |
| 1730682642 | Centennial Medical Group | Family Medicine | 1341 Bedford Drive, Melbourne, FL 32940 | 2018-03-16 |
| 1356849251 | Executive Non-emergency Transportation, Inc. | Non-emergency Medical Transport (VAN) | 3155-02 Suntree Blvd, Melbourne, FL 32940 | 2018-01-25 |
| 1679081160 | Brevard Oaks Center, LLC | Skilled Nursing Facility | 2355 Vidina Drive, Viera, FL 32940 | 2018-01-18 |
| 1275045817 | Comfortable Care Dental Health Professionals. P.a. | Dentist | 6340 N Wickham Rd Ste 101, Melbourne, FL 32940 | 2017-11-03 |
| Find all providers in zip 32940 | ||||
| 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 |
|---|---|---|---|---|
| 1205290913 | Megan Marie Cronin | Dermatology | 1399 S. Harbor City Blvd, Melbourne, FL 32901-3208 | 2016-04-08 |
| 1912217928 | Stuart A Walek Md Pa | Dermatology | 4314 Ligustrum Dr, Melbourne, FL 32934-8603 | 2010-10-12 |
| 1104152495 | Porter Premier Dermatology and Surgery Center, Pllc | Dermatology | 1515 W Nasa Blvd Ste 101, Melbourne, FL 32901-2605 | 2009-10-22 |
| 1174614663 | Stephen H Hornell | Dermatology | 333 E Sheridan Rd, Melbourne, FL 32901-3152 | 2006-09-27 |
| 1942227814 | Sandra K Shrader | Dermatology | 1700 W Hibiscus Blvd, Melbourne, FL 32901-2615 | 2006-07-16 |
| 1023046885 | Peter Mangone Zies | Dermatology | 17 East Silver Palm Avenue, Melbourne, FL 32901-3123 | 2006-06-29 |
| 1013957133 | Anthony Jerome Porter | Dermatology | 1515 W Nasa Blvd, Suite 101, Melbourne, FL 32901-2605 | 2006-06-07 |
| 1275594277 | Rosalind A Freas | Dermatology | 2571 W Eau Gallie Blvd, Suite 2, Melbourne, FL 32935-8954 | 2006-03-29 |
| 1598732471 | Stacia Poole | Dermatology | 930s Harbor City Blvd 101, Melbourne, FL 32901-1901 | 2006-03-01 |
| 1447234000 | Anita Saluja | Dermatology | 6559 N Wickham Rd Ste C-105, Melbourne, FL 32940-2039 | 2005-12-06 |
| Find all providers in MELBOURNE | ||||
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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.