WATER'S EDGE DERMATOLOGY LLC NPI 1871542787

NPI Information

  • NPI: 1871542787
  • Provider Name: WATER'S EDGE DERMATOLOGY, LLC
  • Classification: Clinical Medical Laboratory - 291U00000X
  • Entity Type: Organization
  • Former Legal Business Name: WATER'S EDGE DERMATOLOGY, INC
  • CLIA Number: 10D1021746
  • Address: 600 VILLAGE SQUARE XING
    SUITE 201
    PALM BEACH GARDENS, FL
    ZIP 33410
  • Phone: (561) 721-2400

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NPI Details

WATER'S EDGE DERMATOLOGY, LLC is a clinical medical laboratory in Palm Beach Gardens, FL. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. WATER'S EDGE DERMATOLOGY, LLC NPI is 1871542787. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Water's Edge Dermatology, Inc.

The provider's business location address is:

600 VILLAGE SQUARE XING
SUITE 201
PALM BEACH GARDENS, FL
ZIP 33410-542
Phone: (561) 721-2400
Fax: (561) 721-1249

The provider's authorized official is Susan Davis .
The authorized official title is Dir Billing Operations and has the following contact phone number (561) 693-0540.

The CLIA number assigned to this NPI record is 10D1021746 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/8/2006 and was last updated on 1/27/2016.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1291U00000XClinical Medical Laboratory800019024FLORIDAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1E9145MEDICARE PINFLORIDA

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: 3/30/2025

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