DR. PETER MICHAEL WALLACH (NPI# 1710987391) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710987391 |
| Entity Type | Individual |
| Full Name | DR. PETER MICHAEL WALLACH |
| Credential | M.D. |
| Practice Address |
1480 N University Dr Coral Springs FL 33071-6040 |
| Practice Telephone | 9547531030 |
| Practice Fax Number | 9547531115 |
| Mailing Telephone | 9547531030 |
| Mailing Fax Number | 9547531115 |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2010-07-15 |
| NPI Deactivation Date | 03/21/2006 |
| NPI Reactivation Date | 2006-03-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME0029164 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 057349300 | 05 | |
| FL | RR MEDICARE | 406073297 | 01 |
| FL | CIGNA ID | 4958275 | 01 |
| FL | AETNA ID | 0706177 | 01 |
| FL | GHI PROVIDER ID | 0008978 | 01 |
| Street Address |
1480 N UNIVERSITY DR |
| City | CORAL SPRINGS |
| State | FL |
| Zip Code | 33071-6040 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689693558 | Center for Dermatology Pa | Dermatology | 1480 N University Dr, Coral Springs, FL 33071-6040 | 2006-07-19 |
| 1023077690 | Colette Caputo | Physician Assistant | 1480 N University Dr, Coral Springs, FL 33071-6040 | 2006-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033791 | Wendy Beth Heidkamp | Pharmacist | 8231 Nw 6th Court, Coralsprings, FL 33071 | 2020-08-17 |
| 1265041420 | Shashera Pringle | Nurse Practitioner | 10948 Nw 3rd Street, Coral Springs, FL 33071 | 2020-07-23 |
| 1568084580 | Redsky Solutions, Inc. | Non-emergency Medical Transport (VAN) | 695 Nw 100th Ln, Coral Springs, FL 33071 | 2020-05-13 |
| 1578112991 | Dr G's Pharmacy, Inc | Pharmacy | 2224 N. University Drive, Coral Springs, FL 33071 | 2019-09-09 |
| 1366935447 | Nonye Gali | Occupational Therapy Assistant | 9017 Nw 19th St, Coral Springs, FL 33071 | 2018-06-12 |
| 1255855151 | Elisabet Stumper | Speech-Language Pathologist | 1313 Nw 100th Drive, Coral Springs, FL 33071 | 2017-08-01 |
| 1578093175 | Make It Happen Nursing, LLC | Nursing Care | 8835 Nw 3rd Court, Coral Springs, FL 33071 | 2017-06-15 |
| 1023547304 | Steven Quanhien Thach | Physical Therapist | 2043 N University Dr., Coral Springs, FL 33071 | 2017-06-08 |
| 1083063945 | Health Care Clinic At Walgreens | Clinic/Center | 1724 Nw 126th Dr, Coral Springs, FL 33071 | 2016-06-10 |
| 1902285703 | J&j Comprehensive Medical Care LLC | Internal Medicine | 1505 N. University Drive, Suite 400, Coral Springs, FL 33071 | 2015-05-26 |
| Find all providers in zip 33071 | ||||
| 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 |
|---|---|---|---|---|
| 1992274252 | Kayon Shepherd | Dermatology | 7837 West Sample Rd, #127, Coral Springs, FL 33065 | 2018-11-15 |
| 1255611166 | Nadine George Soro | Dermatology | 3000 N University Dr Ste K, Coral Springs, FL 33065-5082 | 2011-08-23 |
| 1356392294 | Eli Richard Saleeby | Dermatology | 1460 N University Dr, Coral Springs, FL 33071-6040 | 2006-05-15 |
| 1891758165 | Michael Wayne Engelman | Dermatology | 3000 University Dr, Ste K, Coral Springs, FL 33065 | 2006-04-08 |
| 1538122064 | Brooke Ann Lowell | Dermatology | 3000 University Drive, Suite K, Coral Springs, FL 33065 | 2006-04-07 |
| 1043598352 | Hamza Dastgir Bhatti | Dermatology | 1460 N University Dr, Coral Springs, FL 33071-6040 | 2011-08-03 |
| 1295049302 | Justin R Rubin | Dermatology | 1460 N University Dr, Coral Springs, FL 33071-6040 | 2010-07-30 |
| 1366646804 | Kimberly Jennifer Hull | Dermatology | 3000 N University Dr, Suite K, Coral Springs, FL 33065-5055 | 2007-06-11 |
| 1689899734 | Nicole L Grenier | Dermatology | 3000 N University Dr, Suite K, Coral Springs, FL 33065-5055 | 2007-04-16 |
| 1629186523 | Dermatology Consultants of S Fl Pa | Dermatology | 3000 N University Dr, Suite K, Coral Springs, FL 33065-5055 | 2006-08-29 |
| Find all providers in CORAL SPRINGS | ||||
| City | CORAL SPRINGS |
| Zip Code | 33071 |
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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.