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DERMATOLOGY CLINIC PA NPI 1295890853


NPI Information

NPI: 1295890853
Provider Name: DERMATOLOGY CLINIC, PA
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 10D2141328

Address:
880 NW 13TH ST
SUITE 3B
BOCA RATON, FL
ZIP 33486
Phone: (561) 393-0300
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DERMATOLOGY CLINIC, PA is a specialist in Boca Raton, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY CLINIC, PA NPI is 1295890853. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

880 NW 13TH ST
SUITE 3B
BOCA RATON, FL
ZIP 33486-342
Phone: (561) 393-0300
Fax: (561) 393-0048

The provider's authorized official is Stella D Calobrisi .
The authorized official title is Director and has the following contact phone number (561) 393-0300.

The CLIA number assigned to this NPI record is 10D2141328 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/26/2006 and was last updated on 11/23/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialist78997FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1115370OTHERPENNSYLVANIABLUE SHIELD PENN NUMBER
21891717898OTHERFLORIDANPI INDIVIDUAL NUMBER
349480ZOTHERFLORIDAMEDICARE INDIVIDUAL
4G03538MEDICARE UPINFLORIDA
5K1433MEDICARE ID-TYPE UNSPECIFIEDFLORIDAMEDICARE GROUP NUMBER
678997OTHERFLORIDAFLORIDA LICENSE NUMBER
749480OTHERFLORIDAFL BLUE SHIELD NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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