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ADULT AND PEDIATRIC DERMATOLOGY PRACTITIONERS P A
NPI 1417620469
Specialist in Port St Lucie, FL

Active since July 27, 2021
8980 S US HIGHWAY 1 STE 103, PORT ST LUCIE, FL 34952(772) 446-9100(772) 446-9810 Get Directions Write a Review

NPPES record last updated: July 27, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Adult And Pediatric Dermatology Practitioners P A NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADULT AND PEDIATRIC DERMATOLOGY PRACTITIONERS P A (NPI 1417620469) is a healthcare organization registered as a specialist in Port St Lucie, Florida and active in the NPI registry since July 2021. The organization lists Jeffrey T. Masessa, President, as its authorized official.

NPPES Registry Identity

NPI1417620469
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameADULT AND PEDIATRIC DERMATOLOGY PRACTITIONERS P A
Location Address8980 S US HIGHWAY 1 STE 103Port St Lucie, FL 34952-3482
Mailing Address35 Green Pond Rd Ste CRockaway, NJ 07866-2057 · (973) 625-0600
Phone(772) 446-9100
Fax(772) 446-9810
Organization SubpartNo
Authorized OfficialJeffrey T. MasessaPresident · (973) 625-0600
Enumeration DateJuly 27, 2021
NPPES CertifiedJuly 27, 2021
✔ NPI 1417620469 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
8980 S US HIGHWAY 1 STE 103, Port St Lucie, FL 34952
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Other Identifiers 1

OtherMA851FL · Medicare

Group Practice 1

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

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARIELLA JEANINE GARMIZO
Physician Assistant
8980 S US HIGHWAY 1 STE 103
PORT ST LUCIE, FL 34952
St. Lucie County (561) 406-9566

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adult And Pediatric Dermatology Practitioners P A's NPI number?

The NPI number for Adult And Pediatric Dermatology Practitioners P A is 1417620469. It was assigned to this organization in the NPPES registry on July 27, 2021.

Where is Adult And Pediatric Dermatology Practitioners P A located?

Adult And Pediatric Dermatology Practitioners P A is located at 8980 S Us Highway 1 Ste 103, Port St Lucie, FL 34952. The listed phone number is (772) 446-9100.

What is Adult And Pediatric Dermatology Practitioners P A's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Adult And Pediatric Dermatology Practitioners P A was last updated on July 27, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.