MR. CHARLES VINCENT PERNICIARO


Address: 6001 Memorial Hwy, Tampa, FL 33615-4531
Phone: 8138824206

MR. CHARLES VINCENT PERNICIARO (NPI# 1972557890) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972557890
Entity Type Individual
Full Name MR. CHARLES VINCENT PERNICIARO
Credential M.D.
Practice Address 6001 Memorial Hwy
Tampa
FL 33615-4531
Mailing Address Po Box 51498
Jacksonville Beach
FL 32240-1498
Practice Telephone 8138824206
Mailing Telephone 9042410633
Enumeration Date 2006-05-22
Last Update Date 2017-02-10
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207N00000X Dermatology K6231 TX Allopathic & Osteopathic Physicians
N 207N00000X Dermatology 21961 AZ Allopathic & Osteopathic Physicians
N 207N00000X Dermatology 28877 MN Allopathic & Osteopathic Physicians
N 207N00000X Dermatology 017322 LA Allopathic & Osteopathic Physicians
N 207ND0900X Dermatology
Specialization: Dermatopathology
042694 GA Allopathic & Osteopathic Physicians
Y 207ND0900X Dermatology
Specialization: Dermatopathology
51624 FL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
FL BCBS FL 10287 01
GA BCBSGA 52332476003 01
FL MEDICARE RR 070014059 01
GA MEDICARE RR 070014191 01
FL FL MEDAIACRE PTAN HY024A 01
GA 000837075B 05
GA MEDICARE 07BBSHB 01

Office Location

Street Address 6001 MEMORIAL HWY
City TAMPA
State FL
Zip Code 33615-4531

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902895832 John Louis Millns Jr. Dermatology 6001 Memorial Hwy, Tampa, FL 33615-4531 2005-10-13
1386987840 David Poshi Wang Pathology 6001 Memorial Hwy, Tampa, FL 33615-4531 2013-04-03
1124334479 Laura Elaine Millns Dermatology 6001 Memorial Hwy, Tampa, FL 33615-4531 2010-08-25
1649284563 John L Millns Md Pa Dermatology 6001 Memorial Hwy, Tampa, FL 33615-4531 2006-07-28
1982693818 Gulf Coast Dermatopathology Laboratory, Inc. Clinical Medical Laboratory 6001 Memorial Hwy, Tampa, FL 33615-4531 2005-10-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1083125132 The Ida House Assisted Living LLC Assisted Living Facility 6014 Rosewood Dr, Tampa, FL 33615 2017-10-17
1235671785 Magnet Home Health Care Services, LLC Home Health 5700 Memorial Highway Suite G X H 102, Tampa, FL 33615 2016-11-15
1891247532 Martin Esuzor Nurse Practitioner 7918 Hillsborough Avenue, Tampa, FL 33615 2016-10-28
1902263007 Marie E. Simeon Nursing Facility/Intermediate Care Facility 8206 Pennywell Place, Tampa, FL 33615 2016-01-20
1598183659 Mustafa Mohammad Dermatology 6001 Memorial Highway, Tampa, FL 33615 2014-04-04
1710327101 Kelly A Alvarez Case Manager/Care Coordinator 7007 Cobblewood Ct, Tampa, FL 33615 2013-06-28
1336497080 Serenity Home of Tampa Alf LLC Assisted Living Facility 6013 Cresthill Drive, Tampa, FL 33615 2012-08-28
1063777563 Jaime Alexander Pacheco Chiropractor 6301 Memorial Hwy Suit 304, Tampa, FL 33615 2012-07-10
1558656678 Scripts Direct, LLC Pharmacy 8313 W. Hillsborough Ave., # 260, Tampa, FL 33615 2011-06-16
1508178245 The Spring of Tampa Bay Counselor 2810 N. 35 St, Tampa, FL 33615 2010-07-10
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Taxonomy Information

Taxonomy Code 207ND0900X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology
Specialization Dermatopathology

Taxonomy Definition

A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source]
- Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1548739246 Associates & Affiliates In Dermatology LLC Dermatology 5210 Webb Rd Ste B, Tampa, FL 33615-4518 2018-11-26
1598183659 Mustafa Mohammad Dermatology 6001 Memorial Highway, Tampa, FL 33615 2014-04-04
1578603767 Shurun Zhao Dermatology 4431 Waltham Dr, Tampa, FL 33634-7345 2007-02-07
1194735688 Rachel E Careccia Dermatology 12500 N Dale Mabry Hwy Ste D, Tampa, FL 33618 2006-08-08
1023033719 Henry E Wiley IIi Dermatology 1425 S Howard Ave, Tampa, FL 33606-3126 2006-07-13
1437138443 Ruth H Hanno Dermatology 10500 University Center Dr Ste 200, Tampa, FL 33612-6497 2006-01-10
1376529206 Susan E Lenahan Dermatology 4412 W Osborne Ave, Tampa, FL 33614-6963 2005-12-22
1902895832 John Louis Millns Jr. Dermatology 6001 Memorial Hwy, Tampa, FL 33615-4531 2005-10-13
1093061582 Florida Dermatology and Skin Cancer Specialists Pl Dermatology 4200 N Armenia Ave, Ste 1, Tampa, FL 33607-6438 2012-08-02
1154519767 Henry E Wiley IIi Md Pa Dermatology 1425 S Howard Ave, Tampa, FL 33606-3126 2007-10-09
Find all providers in TAMPA

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City TAMPA
Zip Code 33615

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Dataset Information

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.

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