VENICE DERMATOLOGY CLINIC PA NPI 1003007840

Dermatology in Venice, FL

About VENICE DERMATOLOGY CLINIC PA

Venice Dermatology Clinic Pa is a provider in Venice, FL. The NPI number assigned to this provider is 1003007840. The practitioner's primary taxonomy code is Dermatology (207N00000X). The provider is registered as an organization and their NPI record was last updated 6 years ago. Venice Dermatology Clinic Pa operates as a single speciality business group with one or more individual providers who practice the same area of specialization.

NPI1003007840 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider NameVENICE DERMATOLOGY CLINIC PA
Provider Location Address716 THE RIALTO VENICE, FL 34285 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address716 THE RIALTO VENICE, FL 34285 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
NPI Entity TypeOrganization Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?N/A
Is Organization Subpart?No Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date08-07-2007 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date10-04-2011 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

VENICE DERMATOLOGY CLINIC PA
716 THE RIALTO
VENICE, FL
ZIP 34285
Phone: (941) 484-2250
Fax: (941) 484-9638
Get Directions

Mailing Address

VENICE DERMATOLOGY CLINIC PA
716 THE RIALTO
VENICE, FL
ZIP 34285
Phone: (941) 484-2250
Fax: (941) 484-9638

Primary Taxonomy

Taxonomy Code207N00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationDermatology
TypeAllopathic & Osteopathic Physicians
License No.ME69164
License StateFL
Taxonomy DescriptionA 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.

Authorized Official

Authorized Official NameDR. BRUCE A BOYD MD Additional informationCallout TooltipAuthorized official name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.
Authorized Official TitleOWNER
Authorized Official Phone(941) 484-2250

193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
K3312MEDICARE PIN (08)HI
F67550MEDICARE UPIN (02)FL

Map Location


VENICE DERMATOLOGY CLINIC PA address is 716 THE RIALTO VENICE, FL 34285

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1750491494DR. BRUCE ALLEN BOYD MD
Individual
Dermatology716 THE RIALTO
VENICE, FL 34285
(941) 484-2250