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CHARLES PERNICIARO MD PA NPI 1407877392


NPI Information

NPI: 1407877392
Provider Name: CHARLES PERNICIARO MD PA

Doing Business As: NEPTUNE BEACH DERMATOLOGY

Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

Address:
183 LANDRUM LN
SUITE 201
PONTE VEDRA BEACH, FL
ZIP 32082
Phone: (904) 241-0633
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CHARLES PERNICIARO MD PA is a dermatopathology dermatology in Ponte Vedra Beach, FL. The provider is 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. CHARLES PERNICIARO MD PA NPI is 1407877392. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Neptune Beach Dermatology.

The provider's business location address is:

183 LANDRUM LN
SUITE 201
PONTE VEDRA BEACH, FL
ZIP 32082-837
Phone: (904) 241-0633

The provider's authorized official is Charles V. Perniciaro .
The authorized official title is Owner & Physician Provider and has the following contact phone number (904) 241-0633.

The enumeration date for this NPI number is 7/23/2006 and was last updated on 12/5/2014.


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
1207ND0900XDermatologyDermatopathologyYes

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
1K8489MEDICARE ID-TYPE UNSPECIFIEDFLORIDAGROUP 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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