FORT MYERS DERMATOPATHOLOGY
NPI 1366657629
Dermatology - Procedural Dermatology in Estero, FL

NPI Status: Active since May 11, 2007

Contact Information

9250 CORKSCREW RD
SUITE 5
ESTERO, FL
ZIP 33928
Phone: (239) 274-0005
Fax: (239) 278-4718

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  • Organization
  • Dermatology
  • Procedural Dermatology
  • CLIA Number: 10D1012626
  • CLIA Cert. Type: Independent
  • CLIA Exp. Date: 06-24-2027

About FORT MYERS DERMATOPATHOLOGY

This page provides the complete NPI Profile along with additional information for Fort Myers Dermatopathology, a provider established in Estero, Florida operating as a Dermatology, focusing in procedural dermatology . The healthcare provider is registered in the NPI registry with number 1366657629 assigned on May 2007. The practitioner's primary taxonomy code is 207NS0135X. The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mazen Daoud Md (President)

NPI
1366657629
Provider Name
FORT MYERS DERMATOPATHOLOGY
Entity Type
Organization
Location Address
9250 CORKSCREW RD SUITE 5 ESTERO, FL 33928
Location Phone
(239) 274-0005
Location Fax
(239) 278-4718
Mailing Address
8381 RIVERWALK PARK BLVD SUITE 202 FORT MYERS, FL 33919
Mailing Phone
(239) 274-0005
Mailing Fax
(239) 278-4718
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-11-2007
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology Procedural Dermatology

Taxonomy Code
207NS0135X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

Group Taxonomy 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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MAZEN DAOUD MD

Authorized Official Title
PRESIDENT
Authorized Official Phone
(239) 274-0005

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
10D1012626
Facility Type
Independent
Certificate Effective Date
June 25, 2025
Certificate Expiration Date
June 24, 2027
Laboratory Director
DR. MAZEN DAOUD
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Fort Myers Dermatopathology after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1366657629, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
3
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
6
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
5
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
6
Unchanged
Pos 9
2
Doubled → 4
Check
9
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 7 → 14 → 5 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 3 + 1 + 2 + 6 + 1 + 2 + 5 + 1 + 4 + 6 + 4 + 24 = 61

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 61 is 70. The difference is the calculated check digit.

70 - 61 = 9
This NPI is valid
The calculated check digit is 9, which matches the last digit of 1366657629.

Other Providers at the Same Location


The following 12 providers are registered at the same or a nearby location.

Family Medicine
9250 CORKSCREW RD
ESTERO, FL 33928
Chiropractor
9250 CORKSCREW RD, STE 4
ESTERO, FL 33928
Chiropractor
9250 CORKSCREW RD, STE 4
ESTERO, FL 33928
Physical Therapist
9250 CORKSCREW RD, SUITE 10
ESTERO, FL 33928
Podiatrist (Foot & Ankle Surgery)
9250 CORKSCREW RD, SUITE 7
ESTERO, FL 33928
Occupational Therapist
9250 CORKSCREW RD, UNIT 10
ESTERO, FL 33928
Family Medicine
9250 CORKSCREW RD, SUITE 3
ESTERO, FL 33928
Podiatrist (Foot & Ankle Surgery)
9250 CORKSCREW RD, SUITE 7
ESTERO, FL 33928
Podiatrist (Foot & Ankle Surgery)
9250 CORKSCREW RD, SUITE 7
ESTERO, FL 33928
Physical Therapist
9250 CORKSCREW RD, STE 15
ESTERO, FL 33928
Occupational Therapist
9250 CORKSCREW RD
ESTERO, FL 33928
Clinic/Center (Physical Therapy)
9250 CORKSCREW RD, SUITE 10
ESTERO, FL 33928

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1366657629, enumerated as an "organization" on May 11, 2007.

The provider is located at 9250 CORKSCREW RD SUITE 5 ESTERO, FL 33928 and the phone number is (239) 274-0005.

Dermatology with taxonomy code 207NS0135X and a focus in Procedural Dermatology.