FAVREAU DERMATOLOGY LLC (NPI# 1982130985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982130985 |
| Entity Type | Organization |
| Organization Name | FAVREAU DERMATOLOGY LLC |
| Practice Address |
201 Se 14th St Fort Lauderdale FL 33316-1827 |
| Practice Telephone | 9544574201 |
| Mailing Telephone | 9544574201 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |
| Authorized Official Name | MR. MO TOLEDO (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 9544574201 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | OS9004 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
201 SE 14TH ST |
| City | FORT LAUDERDALE |
| State | FL |
| Zip Code | 33316-1827 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871891739 | Clayton M. Berger, M.d., P.a. | Technician/Technologist | 201 Se 14th St, Fort Lauderdale, FL 33316-1827 | 2011-03-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366064040 | Jonathan David Ortiz | Behavior Technician | 1717 Se 4 Ave, Fort Lauderdale, FL 33316 | 2020-05-15 |
| 1306311626 | Gateway Recovery Center, LLC | Counselor | 1421 Sw 4th Avenue, Suite B, Fort Lauderdale, FL 33316 | 2018-10-13 |
| 1588141626 | Natan Bastoky | Family Medicine | 1600 S Andrews Ave # Gme, Fort Lauderdale, FL 33316 | 2018-07-22 |
| 1104320126 | Kathleen Kanani Graham | Pharmacist | 1401 S. Federal Highway, Ft. Lauderdale, FL 33316 | 2018-03-23 |
| 1093224271 | Lacosta Therapy, LLC | Behavioral Analyst | 412 Se 15 St., #4, Ft. Lauderdale, FL 33316 | 2017-09-20 |
| 1124560370 | Yulia Rybalka | Pharmacist | 217 Se 10th Street, Ft Lauderdale, FL 33316 | 2016-11-04 |
| 1730635376 | Brian Alexander Reyes | Specialist/Technologist | 303 Se 3rd Ave, Ft Lauderdale, FL 33316 | 2016-09-01 |
| 1649726282 | Jennifer Tabares | Specialist/Technologist | 303 Southeast 3rd Av, Fort Lauderdale, FL 33316 | 2016-09-01 |
| 1609236850 | Diane Nicole Shilling | Nurse Practitioner | 1001 South Andrews Avenue, Suite 100, Ft. Lauderdale, FL 33316 | 2016-03-01 |
| 1396113239 | Victoria Rosado | Adult Companion | 150 Se 12th Street, 401(b), Fort Lauderdale, FL 33316 | 2015-09-09 |
| Find all providers in zip 33316 | ||||
| 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 |
|---|---|---|---|---|
| 1891352225 | Las Olas Dermatology Inc | Dermatology | 800 E Broward Blvd Ste 507, Fort Lauderdale, FL 33301-2034 | 2019-05-21 |
| 1841556396 | Eric Christopher Wilkerson | Dermatology | 2021 E Commercial Blvd Ste 301, Fort Lauderdale, FL 33308-3754 | 2012-04-10 |
| 1205003068 | Khongruk Wongkittiroch | Dermatology | 2838 E Oakland Park Blvd, Ste 201, Fort Lauderdale, FL 33306-1814 | 2008-05-12 |
| 1316021124 | Peter Leon Babinski | Dermatology | 800 East Broward Blvd, Suite 103, Fort Lauderdale, FL 33301-2020 | 2006-10-25 |
| 1053405415 | Paul J Weber | Dermatology | 5353 North Federal Hwy, Ste 400, Fort Lauderdale, FL 33308 | 2006-10-02 |
| 1427167261 | Jason Green | Dermatology | 5721 Ne 27th Ave, Fort Lauderdale, FL 33308-2703 | 2006-08-29 |
| 1043328230 | Willie Forrest Richardson Jr. | Dermatology | 1120 Bayview Dr, Fort Lauderdale, FL 33304-2505 | 2006-08-28 |
| 1568570778 | Murray Dean Smith | Dermatology | 800 E Broward Blvd, Suite 507, Fort Lauderdale, FL 33301-2034 | 2006-08-28 |
| 1548271976 | Gregory L Perez | Dermatology | 4610 N Federal Highway, Fort Lauderdale, FL 33308 | 2006-08-10 |
| 1801827761 | Mark Bernhardt, Md, Pa | Dermatology | 1601 E Broward Blvd, Fort Lauderdale, FL 33301-2160 | 2006-07-06 |
| Find all providers in FORT LAUDERDALE | ||||
| City | FORT LAUDERDALE |
| Zip Code | 33316 |
Please comment or provide details below to improve the information on FAVREAU DERMATOLOGY LLC.
| 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.