MCDONNELL DERMATOLOGY LLC (NPI# 1609189042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609189042 |
| Entity Type | Organization |
| Organization Name | MCDONNELL DERMATOLOGY LLC |
| Practice Address |
25097 Olympia Ave Ste 204 Punta Gorda FL 33950-3903 |
| Practice Telephone | 9412056676 |
| Mailing Telephone | 9412053376 |
| Enumeration Date | 2010-07-14 |
| Last Update Date | 2010-07-31 |
| Authorized Official Name | JONELLE K MCDONNELL (OWNER) |
| Authorized Official Telephone | 9412053376 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME104122 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICAL LICENSE NUMBER | ME104122 | 01 |
| Street Address |
25097 OLYMPIA AVE STE 204 |
| City | PUNTA GORDA |
| State | FL |
| Zip Code | 33950-3903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013978964 | Nora Ann Davis | Nurse Practitioner | 25097 Olympia Ave, Suite 202, Punta Gorda, FL 33950-3912 | 2006-03-30 |
| 1609310176 | Rubin Family Medicine | Family Medicine | 25097 Olympia Ave, 203, Punta Gorda, FL 33950-3912 | 2016-12-18 |
| 1316254204 | Us Pet Imaging LLC | Radiology | 25097 Olympia Ave, Suite 104, Punta Gorda, FL 33950-3903 | 2010-09-13 |
| 1699944801 | Us Pet Imaging LLC | Radiology | 25097 Olympia Ave, Suite 104, Punta Gorda, FL 33950-3903 | 2008-02-22 |
| 1285736611 | Robert A Henning | Physician Assistant | 25097 Olympia Ave, Punta Gorda, FL 33950-3903 | 2006-09-05 |
| 1780697706 | Ricardo R Martinez | Specialist | 25097 Olympia Ave, Punta Gorda, FL 33950-3903 | 2006-08-14 |
| 1003844937 | Jonelle K Mcdonnell | Specialist | 25097 Olympia Ave, Suite 204, Punta Gorda, FL 33950-3903 | 2006-06-29 |
| 1114978343 | Lawrence R Bachle | Emergency Medicine | 25097 Olympia Ave, Suite 107, Punta Gorda, FL 33950-3903 | 2006-05-12 |
| 1811947302 | Larry R Bachle Do Facoep Pa | Emergency Medicine | 25097 Olympia Ave, Suite 107, Punta Gorda, FL 33950-3903 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295291979 | Kristin Wilson | Nurse Practitioner | 350 E Olympia Ave, Suite 111, Punta Gorda, FL 33950 | 2019-02-18 |
| 1750856993 | Medical Risk Solutions | Family Medicine | 514 East Grace Street, Punta Gorda, FL 33950 | 2018-10-03 |
| 1457858607 | Janet Miller Dawson | Nurse Practitioner | Charlotte Behavioral Health Care, 1700 Education Avenue, Punta Gorda, FL 33950 | 2018-04-12 |
| 1730689290 | Suncoast Neuropsychiatric Wellness Center LLC | Psychiatry & Neurology | 25097 E Olympia Ave, #200, Punta Gorda, FL 33950 | 2018-02-20 |
| 1306351424 | Laura Cara Carlisle | Developmental Therapist | 2440 W Marion Ave, Punta Gorda, FL 33950 | 2017-12-12 |
| 1629591722 | Rachel Guyton Irias | Behavior Technician | 321 W Grace St, Punta Gorda, FL 33950 | 2017-07-20 |
| 1730636713 | William Bartley Hoke | Specialist/Technologist | 733 E.oympia Ave, Punta Gorda, FL 33950 | 2016-09-07 |
| 1861868770 | Jason Burns | Physical Therapist | 3857 Acline Rd Unit 107, Punta Gorda, FL 33950 | 2015-08-14 |
| 1073935409 | Heather Lynn Darmetko | Nurse Practitioner | 713 E. Marion Ave. 1211 Suite 1211, Punta Gorda, FL 33950 | 2014-01-21 |
| 1568706380 | Steven Michael Byrne | Nurse Practitioner | 2310 Tamiami Trail, Suite 2101, Punta Gorda, FL 33950 | 2012-11-16 |
| Find all providers in zip 33950 | ||||
| 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 |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | PUNTA GORDA |
| Zip Code | 33950 |
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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.