SCOTT HOWARD DECKELBAUM (NPI# 1730100892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1730100892 |
Entity Type | Individual |
Full Name | SCOTT HOWARD DECKELBAUM |
Credential | DO |
Practice Address |
603 N Flamingo Rd Ste 350 Pembroke Pines FL 33028-1013 |
Mailing Address |
15051 S Tamiami Trl Ste 203 Fort Myers FL 33908-5182 |
Practice Telephone | 9544355100 |
Practice Fax Number | 9543851533 |
Mailing Telephone | 2394378810 |
Mailing Fax Number | 2393132555 |
Enumeration Date | 2006-07-22 |
Last Update Date | 2018-02-28 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207N00000X | Dermatology | 235559 | NY | Allopathic & Osteopathic Physicians |
N | 207N00000X | Dermatology | 5176 | OK | Allopathic & Osteopathic Physicians |
N | 207N00000X | Dermatology | 20A10789 | CA | Allopathic & Osteopathic Physicians |
Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
OS14334 | FL | Allopathic & Osteopathic Physicians |
N | 207Q00000X | Family Medicine | 5176 | OK | Allopathic & Osteopathic Physicians |
N | 207Q00000X | Family Medicine | 20A10789 | CA | Allopathic & Osteopathic Physicians |
N | 207Q00000X | Family Medicine | 235559-1 | NY | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | 02806417 | 05 |
Address | Telephone Number | Fax Number |
---|---|---|
250 Delaware Ave, Suite 207, Delmar, NY 120541401 | 5186900789 | 5186410098 |
Street Address |
603 N FLAMINGO RD STE 350 |
City | PEMBROKE PINES |
State | FL |
Zip Code | 33028-1013 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821570276 | Grace Olivine Lue | Nurse Practitioner | 2291 Nw 171 Terrace, Pembroke Pines, FL 33028 | 2018-09-02 |
1336658194 | Edna Daniel | Registered Nurse | 16213 Nw 18th Street, Pembroke Pines, FL 33028 | 2017-09-25 |
1093257032 | Carlos Eduardo Florian Jr. | Physical Therapist | 701 North Flamingo Road, Pembroke Pines, FL 33028 | 2016-11-08 |
1760868574 | Clara Elisa Delgado | Nurse Practitioner | 601 N Flamingo Road Suite 105, Pembroke Pines, FL 33028 | 2015-08-04 |
1942614375 | Emmanuel Magboo | Physical Therapist | 1563 Nw 159 Lane, Pembroke Pines, FL 33028 | 2014-06-13 |
1134546302 | Tahnie Danastor | Obstetrics & Gynecology | 601 N Flamingo Rd Ste 307, Pembroke Pines, FL 33028 | 2014-03-25 |
1316388200 | Mirella Silva-bass | Counselor | 2250 Nw 136 Ave # 100f, Pembroke Pines, FL 33028 | 2013-07-09 |
1932447364 | Grazia Oropesa | Nurse Practitioner | 12824 Nw 21st St, Pembroke Pines, FL 33028 | 2013-01-18 |
1548545320 | Rita Galliano | Speech-Language Pathologist | 1261 Nw 141st Ave, Pembroke Pines, FL 33028 | 2011-10-12 |
1033429949 | Paulette Paul | Registered Nurse | 15575 N.w. 12th Court, Pembroke Pines, FL 33028 | 2010-10-13 |
Find all providers in zip 33028 |
Taxonomy Code | 207ND0101X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
Specialization | MOHS-Micrographic Surgery |
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
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1144827577 | Onspot-fl LLC. | Dermatology | 16461 Domestic Ave, Fort Myers, FL 33912-6008 | 2020-10-08 |
1942855150 | International Dermatology Research, Inc. | Dermatology | 8370 W Flagler St Ste 200, Miami, FL 33144-2038 | 2019-08-05 |
1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
1437517802 | Total Vein and Skin LLC | Dermatology | 10383 Hagen Ranch Road, Ste 100, Boynton Beach, FL 33437-3732 | 2016-02-01 |
1861812851 | Anand Haryani | Dermatology | 8745 N Us Highway 1, Sebastian, FL 32958-7524 | 2014-04-17 |
1164841797 | Michael Montuno | Dermatology | 38135 Market Sq Ste 108, Zephyrhills, FL 33542-7505 | 2014-04-10 |
1861813719 | Hillcrest Dermatology and Plastic Surgery P.a. | Dermatology | 733 Highway 466, Lady Lake, FL 32159-6340 | 2013-12-19 |
1922355957 | Florida Medical Specialists | Dermatology | 4351 Cortez Rd W, Suite 101, Bradenton, FL 34210 | 2012-08-09 |
1619232501 | Alliant Dermatology Pa | Dermatology | 8620 E County Road 466, The Villages, FL 32162-3670 | 2012-07-07 |
1114218328 | Leavitt Medical Assocaittes of Florida Inc | Dermatology | 1426 E Bloomindale Ave, Valrico, FL 33596 | 2011-04-21 |
Find all providers with the same taxonomy |
City | PEMBROKE PINES |
Zip Code | 33028 |
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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.