ELITE DERMATOLOGY AND AESTHETIC INSTITUTE, LLC (NPI# 1154735819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154735819 |
| Entity Type | Organization |
| Organization Name | ELITE DERMATOLOGY AND AESTHETIC INSTITUTE, LLC |
| Other Organization Name | ELITE MEDICINE AND AESTHETIC INSTITUTE |
| Practice Address |
1905 Clint Moore Rd Suite 203 Boca Raton FL 33496-2658 |
| Practice Telephone | 5618266650 |
| Practice Fax Number | 5618266649 |
| Mailing Telephone | 5618266650 |
| Mailing Fax Number | 5618266649 |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2015-11-19 |
| Authorized Official Name | FAWN WINKELMAN (PRESIDENT) |
| Authorized Official Telephone | 5618266650 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | OS1629 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE PTAN | 11877A | 01 |
| Other Name | Type Code |
|---|---|
| ELITE MEDICINE AND AESTHETIC INSTITUTE | Doing Business As Name - Organization |
| Street Address |
1905 CLINT MOORE RD SUITE 203 |
| City | BOCA RATON |
| State | FL |
| Zip Code | 33496-2658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831174242 | Brian K Kaplan | Internal Medicine | 1905 Clint Moore Rd, Suite 204, Boca Raton, FL 33496-2658 | 2005-12-08 |
| 1255970760 | Exillette Etienne Camille | Nurse Practitioner | 1905 Clint Moore Rd, Boca Raton, FL 33496-2658 | 2019-12-31 |
| 1578914800 | Jennifer Maria Gold | Physician Assistant | 1905 Clint Moore Rd, Suite 215, Boca Raton, FL 33496-2658 | 2016-06-28 |
| 1083073423 | Mr Health Group LLC | Clinic/Center | 1905 Clint Moore Rd, Ste 305, Boca Raton, FL 33496-2658 | 2016-02-13 |
| 1578932216 | Caroline E Rangel | Physician Assistant | 1905 Clint Moore Rd, Suite 309, Boca Raton, FL 33496-2658 | 2015-09-23 |
| 1083092829 | Central Palm Beach Physicians & Urgent Care Inc | Specialist | 1905 Clint Moore Rd, Suite 308, Boca Raton, FL 33496-2658 | 2015-05-13 |
| 1114304102 | Daniel S. Kovacs, M.d., P.a. | Plastic Surgery | 1905 Clint Moore Rd, Suite 101, Boca Raton, FL 33496-2658 | 2015-04-29 |
| 1497145957 | Stewart M. Kaskel M.d. | Internal Medicine | 1905 Clint Moore Rd, Ste 310, Boca Raton, FL 33496-2658 | 2015-02-04 |
| 1427490002 | Cranial Technologies Inc | Prosthetic/Orthotic Supplier | 1905 Clint Moore Rd, Suite 301, Boca Raton, FL 33496-2658 | 2013-07-23 |
| 1922441005 | Steven Schuster M.d., P.a. | Plastic Surgery | 1905 Clint Moore Rd, Suite 101, Boca Raton, FL 33496-2658 | 2013-04-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275193708 | Georgia Management Group | Health Maintenance Organization | 9878 Clint Moore Rd Suite 206, Boca Raton, FL 33496 | 2019-06-17 |
| 1326505710 | Capital Ortho LLC | Durable Medical Equipment & Medical Supplies | 6599 Newport Lake Cir, Boca Raton, FL 33496 | 2019-02-21 |
| 1710409636 | Armando Rodriguez | Specialist/Technologist | 9975 Boca Gardens Trail, Unit C, Boca Raton, FL 33496 | 2017-07-12 |
| 1942721782 | Lang Thi Woodmansee | Optometrist | 17940 S Military Trl Ste 400, Boca Raton, FL 33496 | 2017-07-02 |
| 1710325006 | Home Care Assistance of South Florida, LLC | Home Health | 3050 Champion Blvd., Boca Raton, FL 33496 | 2013-06-07 |
| 1568704450 | Gary J Edman | Physician Assistant | 4705 N Federal Highway, Boca Raton, FL 33496 | 2013-03-19 |
| 1396065512 | Holiday Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 6651 N. Military Trail, Suite 100, Boca Raton, FL 33496 | 2010-06-10 |
| 1265765093 | Mark Alan Needle | Internal Medicine | 2231 Nw 58 St, Boca Raton, FL 33496 | 2009-09-11 |
| 1780834036 | Richard Allen Peshkin | General Practice | 5227-a Lake Catalina Dr. N, Boca Raton, FL 33496 | 2008-09-23 |
| 1073712071 | Ehsan Esmaeili | Surgery | 1905 Clint Moore Rd., Suite 105, Boca Raton, FL 33496 | 2007-07-11 |
| Find all providers in zip 33496 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134728561 | Invision Health Florida, LLC | Family Medicine | 7100 Camino Real Ste 200, Boca Raton, FL 33433-5510 | 2020-10-17 |
| 1710584537 | Daniel Beck | Family Medicine | 6511 Via Regina, Boca Raton, FL 33433-3910 | 2020-10-05 |
| 1265057715 | Danit Fischtein | Family Medicine | 8350 Via Serena, Boca Raton, FL 33433-2235 | 2020-06-10 |
| 1396366209 | Mirna L Avendano | Family Medicine | 4998 Nw 3rd Ter, Boca Raton, FL 33431-4767 | 2020-05-01 |
| 1083256168 | Glutality Provider Group, P.a. | Family Medicine | 6800 Broken Sound Pkwy Nw Ste 150a, Boca Raton, FL 33487-5709 | 2019-10-10 |
| 1912401027 | Matthew Morrison | Family Medicine | 64 S Federal Hwy, Boca Raton, FL 33432-4805 | 2018-03-22 |
| 1588013049 | Dianela Medina Vega | Family Medicine | 2900 N Military Trl Ste 201, Boca Raton, FL 33431-6308 | 2016-06-06 |
| 1265822712 | Betsy Leibowitz | Family Medicine | 101 Plaza Real S Ste A, Boca Raton, FL 33432-4855 | 2015-02-04 |
| 1629487939 | Duhaney Medical, P.a. | Family Medicine | 9808 Grand Verde Way, 802, Boca Raton, FL 33428-3516 | 2014-08-12 |
| 1699106948 | John Habib Hanna | Family Medicine | 1180 South Ocean Blvd, Suite Number 10-a, Boca Raton, FL 33432-7639 | 2013-12-11 |
| Find all providers in BOCA RATON | ||||
| City | BOCA RATON |
| Zip Code | 33496 |
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| 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.