VENICE DERMATOLOGY CLINIC PA (NPI# 1801369020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801369020 |
| Entity Type | Organization |
| Organization Name | VENICE DERMATOLOGY CLINIC PA |
| Practice Address |
3171 Bobcat Village Center Rd North Port FL 34288-8974 |
| Mailing Address |
1219 Jacaranda Blvd Venice FL 34292-4520 |
| Practice Telephone | 9414842250 |
| Mailing Telephone | 9414842250 |
| Mailing Fax Number | 9414849638 |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |
| Authorized Official Name | DR. BRUCE ALLEN BOYD (M.D./OWNER) |
| Authorized Official Telephone | 9414842250 |
| Is Organization Subpart | Y |
| Parent Organization Name | VENICE DERMATOLOGY CLINIC PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Reviance Dermatology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003007840 | Venice Dermatology Clinic Pa | Dermatology | 716 The Rialto, Venice, FL 34285-3524 | 2007-08-07 |
| Street Address |
3171 BOBCAT VILLAGE CENTER RD |
| City | NORTH PORT |
| State | FL |
| Zip Code | 34288-8974 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245787795 | Hope Diana | Dental Hygienist | 3026 Seth Road, North Port, FL 34288 | 2016-09-01 |
| 1942402946 | Melinda Wilson | Physical Therapy Assistant | 5999 Bibb Court, North Port, FL 34288 | 2007-06-01 |
| 1447314190 | Girish D. Patel | Internal Medicine | 2500 Bobcat Village Center Rd, Suite E, North Port, FL 34288 | 2006-12-20 |
| 1295804649 | Francisco V Ramirez IIi | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2006-11-07 |
| 1104878016 | William L Crouch Iv | Family Medicine | 2630 Bobcat Village Center Road, North Port, FL 34288 | 2006-05-17 |
| 1700398864 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 1500 Price Creek Way, North Port, FL 34288 | 2017-10-30 |
| 1629517321 | Ketul Shah | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2017-02-15 |
| 1881835569 | Northport Emergency Associates, Pa | Emergency Medicine | 2345 Bobcat Village Center Rd, North Port, FL 34288 | 2009-03-10 |
| 1417085069 | Pieter H. Tepaske | Physical Therapist | 2530 Bobcat Village Center Rd Unit C, North Port, FL 34288 | 2007-03-02 |
| 1932576733 | Erika Miley | Counselor | 1121 W Price Blvd # 107, North Port, FL 34288-1814 | 2015-08-27 |
| Find all providers in zip 34288 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646930 | Neil Sandhu Pa | Dermatology | 1431 Orange Camp Rd Ste 115, Deland, FL 32724-7770 | 2020-07-08 |
| 1548739246 | Associates & Affiliates In Dermatology LLC | Dermatology | 5210 Webb Rd Ste B, Tampa, FL 33615-4518 | 2018-11-26 |
| 1558836445 | Docta LLC | Dermatology | 5200 S University Dr Ste 102a, Davie, FL 33328-5316 | 2018-10-08 |
| 1598183659 | Mustafa Mohammad | Dermatology | 6001 Memorial Highway, Tampa, FL 33615 | 2014-04-04 |
| 1609215912 | Nosky P.a. | Dermatology | 512 Cypress Parkway, Poinciana, FL 34759 | 2013-06-19 |
| 1487098059 | Jason R Rosen | Dermatology | 4675 Linton Blvd Ste 203b, Delray Beach, FL 33445-6615 | 2013-04-25 |
| 1881964864 | Harold Edward Garber | Dermatology | 605 San Marco Dr, Fort Lauderdale, FL 33301-2547 | 2012-01-06 |
| 1245523414 | Sanchez Dermatology Services | Dermatology | 420 N Plant Ave, Plant City, FL 33563-7248 | 2011-05-22 |
| 1316244379 | Teresa C Rey | Dermatology | 3760 Sw 139th Pl, Miami, FL 33175-6749 | 2011-02-26 |
| 1902107592 | Sunshine Dermatopathology Pa | Dermatology | 1 N Ocean Blvd, # 806, Pompano Beach, FL 33062-5733 | 2010-11-12 |
| Find all providers with the same taxonomy | ||||
| City | NORTH PORT |
| Zip Code | 34288 |
Please comment or provide details below to improve the information on VENICE DERMATOLOGY CLINIC PA.
| 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.