DR. MICHELLE LUNDEEN PENNIE (NPI# 1497932784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497932784 |
| Entity Type | Individual |
| Full Name | DR. MICHELLE LUNDEEN PENNIE |
| Credential | MD |
| Practice Address |
900 Pine St Ste 122-123 Englewood FL 34223-4418 |
| Mailing Address |
900 Pine St Ste 123 Englewood FL 34223-4418 |
| Practice Telephone | 9414748811 |
| Practice Fax Number | 9414730058 |
| Mailing Telephone | 9414748811 |
| Mailing Fax Number | 9414730058 |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2012-12-22 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME108521 | FL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 2010011561 | MO | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 002099 | GA | Allopathic & Osteopathic Physicians |
| Street Address |
900 PINE ST STE 122-123 |
| City | ENGLEWOOD |
| State | FL |
| Zip Code | 34223-4418 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316930092 | Mark Konwiser | Specialist | 900 Pine St, Bldg 1 Ste 122/123, Englewood, FL 34223-4418 | 2005-08-26 |
| 1639731524 | Eva Maria Pirro | Pediatrics | 900 Pine St, Englewood, FL 34223-4418 | 2019-07-01 |
| 1598122012 | Susan A Mccann | Nurse Practitioner | 900 Pine St, Suite #123, Englewood, FL 34223-4418 | 2016-01-28 |
| 1639506348 | Megan Bender | Physician Assistant | 900 Pine St, Englewood, FL 34223-4418 | 2013-09-26 |
| 1558620385 | Michelle Pennie Md LLC | Dermatology | 900 Pine St, Ste 122-123, Englewood, FL 34223-4418 | 2012-05-14 |
| 1174810642 | Drs. Raja & Raja, Pa | Specialist | 900 Pine St, Suite 215, Englewood, FL 34223-4418 | 2011-07-06 |
| 1588962922 | Gulf Coast Hma Physician Management LLC | Family Medicine | 900 Pine St, Englewood, FL 34223-4418 | 2011-03-09 |
| 1750682175 | James Villotti Md Pa | Family Medicine | 900 Pine St, Suite 111, Englewood, FL 34223-4418 | 2010-11-17 |
| 1841492956 | Cara Overbeck Dds Pa | Dentist | 900 Pine St, Suite 121, Englewood, FL 34223-4418 | 2007-06-01 |
| 1245445014 | Renee Lynn Stevens | Physical Therapist | 900 Pine St, Ste. 127, Englewood, FL 34223-4418 | 2007-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180285 | Shelby Katherine Chirillo | Behavior Technician | 2500 Bobcat Center, Suite G, North Port, FL 34223 | 2018-10-16 |
| 1073022885 | Stacey Jo Seitz | Nurse Practitioner | 900 Pine Street, Suite 222, Englewood, FL 34223 | 2017-09-25 |
| 1750823688 | Bernice Cynthia Putnam | Technician | 401 E Langsner St, Englewood, FL 34223 | 2016-11-09 |
| 1003366949 | Tiffany Kristine Lamarca | Nurse Practitioner | 2061 Englewood Rd Ste 5, Englewood, FL 34223 | 2016-10-04 |
| 1336578293 | Lawrence Hale | Dentist | 701 S Indiana Ave Ste A, Englewood, FL 34223 | 2013-11-01 |
| 1730404310 | Michael A Arpasi | Hearing Instrument Specialist | 1720 S Mccall Rd Ste H, Englewood, FL 34223 | 2010-04-07 |
| 1962657452 | Amy J. Culbertson | Nurse Practitioner | 1719 Gale St, Englewood, FL 34223 | 2008-11-25 |
| 1396884433 | Cynthia J Juliao | Audiologist | 1108 Larchmont Dr, Englewood, FL 34223 | 2007-02-05 |
| 1538224092 | Cynthia Kay Davis | Obstetrics & Gynecology | 2061 Englewood Rd Ste 1, Englewood, FL 34223 | 2006-12-26 |
| 1902966146 | Dennis M Jewell Dc Pa | Chiropractor | 579 South Indiana Ave, Suite C, Englewood, FL 34223 | 2006-12-11 |
| Find all providers in zip 34223 | ||||
| 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 |
|---|---|---|---|---|
| 1326521576 | Kaitlyn Laurel Pell | Dermatology | 125 Inverness Dr E Ste 340, Englewood, CO 80112-5139 | 2018-09-13 |
| 1417357922 | Premier Dermatology, LLC | Dermatology | 900 Pine Street 122 / 123, Englewood, FL 34233-0000 | 2014-09-03 |
| 1558623496 | Annelise Lorelei Dawson | Dermatology | 499 E Hampden Ave Ste 390, Englewood, CO 80113 | 2012-06-15 |
| 1093819369 | Kimberly C Stone | Dermatology | 3701 S Clarkson St, Ste 300, Englewood, CO 80113-3960 | 2006-09-08 |
| 1063493898 | Chang Bae Son | Dermatology | 200 Grand Ave 201, Englewood, NJ 07631-4363 | 2005-11-09 |
| 1134691058 | Dawson Dermatology Group Pllc | Dermatology | 499 E Hampden Ave Ste 390, Englewood, CO 80113-2780 | 2018-12-18 |
| 1811472111 | Englewood Dermatology Center | Dermatology | 300 Grand Ave Ste 201, Englewood, NJ 07631-6300 | 2018-10-02 |
| 1104274919 | Forefront Dermatology, S.c. | Dermatology | 5 W Wenger Rd, Englewood, OH 45322 | 2016-06-02 |
| 1922341783 | Jisun Cha Md | Dermatology | 460 Sylvan Ave, Englewood, NJ 07632-2919 | 2013-03-30 |
| 1497010250 | Tanya Nicole Riddle | Dermatology | 3701 S Clarkson St Ste 400, Englewood, CO 80113-3960 | 2012-07-09 |
| Find all providers in ENGLEWOOD | ||||
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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.