RENEWAL DERMATOLOGY & MEDSPA, P.C. (NPI# 1619232469) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619232469 |
| Entity Type | Organization |
| Organization Name | RENEWAL DERMATOLOGY & MEDSPA, P.C. |
| Practice Address |
7512 Gardner Park Dr Gainesville VA 20155-3414 |
| Practice Telephone | 7037539860 |
| Practice Fax Number | 7037539863 |
| Mailing Telephone | 7037539860 |
| Mailing Fax Number | 7037539863 |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |
| Authorized Official Name | KURT L MAGGIO (PRESIDENT) |
| Authorized Official Telephone | 7037539860 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
7512 GARDNER PARK DR |
| City | GAINESVILLE |
| State | VA |
| Zip Code | 20155-3414 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598787756 | Kurt Laurence Maggio | Dermatology | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2006-07-24 |
| 1306463930 | Mark Gibbs | Nurse Practitioner | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2020-06-30 |
| 1619263407 | Renewal Dermatology Pllc | Dermatology | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2011-06-21 |
| 1831324144 | Renewal Dermatology Pllc | Dermatology | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2009-05-17 |
| 1760647374 | Amanda Lynn Malgieri | Physician Assistant | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2008-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932689387 | Debbie Ruth Romero | Massage Therapist | Gainesville Holistic Health Center, 8006 Crescent Park Drive, Gainesville, VA 20155 | 2018-08-15 |
| 1821587114 | Anh T. Pham, Dds, General Dentistry, PC | Dentist | 7544 Gardner Park Dr., Gainesville, VA 20155 | 2018-05-02 |
| 1982118618 | Renew Counseling and Services | Social Worker | 14540 John Marshall Highway, Gainesville, VA 20155 | 2017-11-16 |
| 1952831745 | Lauren Gutta Matini | Dentist | 13801 Heathcote Blvd, 100, Gainesville, VA 20155 | 2017-06-14 |
| 1023546611 | Dentists of Gainesville, PC | Dentist | 8140 Stonewall Shops Square, Gainesville, VA 20155 | 2017-05-26 |
| 1538600036 | Prince William H&r Ops Limited Partnership | Skilled Nursing Facility | 14935 Holly Knoll Lane, Gainesville, VA 20155 | 2017-03-16 |
| 1396191870 | Isg Transport, LLC | Non-emergency Medical Transport (VAN) | 7653 Framingham Ct., Gainesville, VA 20155 | 2016-05-13 |
| 1831518356 | Alvorada Dentistry | Dentist | 13922 Estate Manor Drive, Gainesville, VA 20155 | 2014-04-11 |
| 1215352547 | Pamco Care LLC | Community/Behavioral Health | 7316 Respite Court, Gainesville, VA 20155 | 2014-02-24 |
| 1598109787 | Nader Nagy Hanna | Pharmacist | 14334 Broadwinged Dr, Gainesville, VA 20155 | 2013-04-18 |
| Find all providers in zip 20155 | ||||
| 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 |
|---|---|---|---|---|
| 1053602128 | Vlatka Agnetta | Dermatology | 4037 Nw 86th Ter Fl 4, Gainesville, FL 32606-9277 | 2011-04-25 |
| 1245521251 | Marjorie E Montanez-wiscovich | Dermatology | 1600 Sw Archer Rd # 100279, Gainesville, FL 32610-3003 | 2011-04-25 |
| 1104051515 | Sailesh Konda | Dermatology | 4037 Nw 86th Ter, 4th Floor, Gainesville, FL 32606-9277 | 2009-05-29 |
| 1104081322 | Reena Moza Vaid | Dermatology | 7500 Gardner Park Dr, Gainesville, VA 20155-3414 | 2008-07-28 |
| 1972708329 | Daven Navnit Doshi | Dermatology | 4525 Sw 13th St, Gainesville, FL 32608-3901 | 2007-06-17 |
| 1821157116 | Dermatology Associates Ne Ga | Dermatology | 974 South Enota Drive Ne, Gainesville, GA 30501 | 2006-12-06 |
| 1275628562 | Betsy B Beers | Dermatology | 350 Nw 76 Drive, Suite A, Gainesville, FL 32607 | 2006-10-04 |
| 1861504516 | Ruth C Wilkerson | Dermatology | 4850 Sw 91 Terrace, Ste P 102, Gainesville, FL 32608-6038 | 2006-08-31 |
| 1598787756 | Kurt Laurence Maggio | Dermatology | 7512 Gardner Park Dr, Gainesville, VA 20155-3414 | 2006-07-24 |
| 1437109899 | Lanier Dermatology & Skin Cancer Specialists, PC | Dermatology | 605 S Enota Dr Ne, Gainesville, GA 30501-2437 | 2006-05-10 |
| Find all providers in GAINESVILLE | ||||
| City | GAINESVILLE |
| Zip Code | 20155 |
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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.