MRS. KRISTIN WIDICK SMALLWOOD (NPI# 1346350352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346350352 |
| Entity Type | Individual |
| Full Name | MRS. KRISTIN WIDICK SMALLWOOD |
| Credential | M.D. |
| Practice Address |
1980 N Atlantic Ave Suite 722 Cocoa Beach FL 32931-5213 |
| Practice Telephone | 3217848811 |
| Practice Fax Number | 3217994424 |
| Mailing Telephone | 3217848811 |
| Mailing Fax Number | 3217994424 |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207N00000X | Dermatology | 0056367 | FL | Allopathic & Osteopathic Physicians |
| X | 207NI0002X |
Dermatology Specialization: Clinical & Laboratory Dermatological Immunology |
0056367 | FL | Allopathic & Osteopathic Physicians |
| X | 207NP0225X |
Dermatology Specialization: Pediatric Dermatology |
0056367 | FL | Allopathic & Osteopathic Physicians |
| X | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
0056367 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
1980 N ATLANTIC AVE SUITE 722 |
| City | COCOA BEACH |
| State | FL |
| Zip Code | 32931-5213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467459883 | Elliot Harold Kornberg | Surgery | 1980 N Atlantic Ave, Suite 416, Cocoa Beach, FL 32931-5213 | 2005-06-30 |
| 1154794071 | Kelli M. Cordis, Lcsw | Community/Behavioral Health | 1980 N Atlantic Ave, Suite 616, Cocoa Beach, FL 32931-5213 | 2015-11-02 |
| 1962759035 | Joseph B. Glasner, M.d., P.a. | Family Medicine | 1980 N Atlantic Ave, Suite 627, Cocoa Beach, FL 32931-5213 | 2012-08-08 |
| 1932491461 | Misty Faith Marot | Behavioral Analyst | 1980 N Atlantic Ave, Suite 416, Cocoa Beach, FL 32931-5213 | 2011-05-02 |
| 1013212299 | Tamara Pawich | Psychologist | 1980 N Atlantic Ave, Cocoa Beach, FL 32931-5213 | 2011-01-19 |
| 1316100548 | Richard F. Lamacchia, Phd, Pa | Clinic/Center | 1980 N Atlantic Ave, Suite 515, Cocoa Beach, FL 32931-5213 | 2008-07-08 |
| 1558529842 | Mihai S Radu M D P A | Clinic/Center | 1980 N Atlantic Ave, Ste 718, Cocoa Beach, FL 32931-5213 | 2008-05-23 |
| 1801084280 | D L Shannon and Associates Inc | Social Worker | 1980 N Atlantic Ave, Suite 515, Cocoa Beach, FL 32931-5213 | 2007-10-10 |
| 1316147606 | Surgical Specialists of Central Brevard Pa | Surgery | 1980 N Atlantic Ave, Suite 602, Cocoa Beach, FL 32931-5213 | 2007-07-24 |
| 1770632267 | Donald A, Stewart | Psychologist | 1980 N Atlantic Ave, Suite 501, Cocoa Beach, FL 32931-5213 | 2007-01-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699275016 | Daniel Edgar Ferrier | Specialist/Technologist | 741 S Orlando Ave Apt B, Cocoa Beach, FL 32931 | 2018-02-13 |
| 1891206793 | Peace Club Inc. | Counselor | 1811 S. Orlando Avenue, Cocoa Beach, FL 32931 | 2017-10-18 |
| 1811384696 | Magnolia House Assisted Living Facility LLC | Assisted Living Facility | 103 Yacht Haven Drive, Cocoa Beach, FL 32931 | 2015-04-20 |
| 1801236807 | Muhammad Ishfaq | Internal Medicine | 701 W Cocoa Beach Causeway, Cocoa Beach, FL 32931 | 2013-07-05 |
| 1053658799 | Charles King | Pharmacist | 2067 North Atlantic Ave, Cocoa Beach, FL 32931 | 2013-01-15 |
| 1033464441 | Cori Megan Daniels | Nurse Practitioner | 1980 N. Atlantic Ave, Suite 627, Cocoa Beach, FL 32931 | 2012-07-23 |
| 1871850313 | Adel Tadros Fahmy | Obstetrics & Gynecology | 68 Country Club Road, Cocoa Beach, FL 32931 | 2012-04-23 |
| 1497021760 | Armstrong Chiropractic Family Center, Inc. | Clinic/Center | 1401 N. Atlantic Ave., Cocoa Beach, FL 32931 | 2012-03-30 |
| 1710261516 | Jill L Carey | Speech-Language Pathologist | 50 Country Club Rd, Cocoa Beach, FL 32931 | 2011-09-28 |
| 1700173416 | Barbara Greene | Registered Nurse | 26 West Point Drive, Cocoa Beach, FL 32931 | 2011-07-01 |
| Find all providers in zip 32931 | ||||
| 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 |
|---|---|---|---|---|
| 1831247832 | Donna Marie Yonkosky | Dermatology | 1890 N Atlantic Ave, Cocoa Beach, FL 32931-3291 | 2007-01-08 |
| 1861884173 | Dr. Betsy Leveritt, D.o. | Dermatology | 80 Woodland Ave, Cocoa Beach, FL 32931-2854 | 2015-02-24 |
| 1306957378 | Atlantic Dermatology LLC | Dermatology | 1980 N Atlantic Ave, Suite 722, Cocoa Beach, FL 32931-5213 | 2006-08-31 |
| 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 |
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| City | COCOA BEACH |
| Zip Code | 32931 |
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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.