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JOHNNY GURGEN DO PA
NPI 1770856833
Dermatology in Lady Lake, FL

Active since February 20, 2012CLIA Certified · 2 labs
920 ROLLING ACRES RD UNIT 203, LADY LAKE, FL 32159(352) 435-7695(352) 435-7453 Get Directions Write a Review

NPPES record last updated: November 18, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 18, 2019, Jun 11, 2019, Sep 27, 2018 (3 updates tracked since 2018).

About Johnny Gurgen Do Pa NPPES

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

JOHNNY GURGEN DO PA (NPI 1770856833) is a healthcare organization registered as a dermatology in Lady Lake, Florida and active in the NPI registry since February 2012. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Leesburg, and lists Johnny Gurgen, Owner, as its authorized official.

NPPES Registry Identity

NPI1770856833
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameJOHNNY GURGEN DO PA
Location Address920 ROLLING ACRES RD UNIT 203Lady Lake, FL 32159-5029
Mailing Address920 Rolling Acres Rd Unit 203Lady Lake, FL 32159-5029 · (352) 435-7695 · Fax (352) 435-7453
Phone(352) 435-7695
Fax(352) 435-7453
Organization SubpartNo
Authorized OfficialJohnny GurgenOwner · (352) 435-7695
Enumeration DateFebruary 20, 2012
Last NPPES UpdateNovember 18, 20193 updates tracked since enumeration
✔ NPI 1770856833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
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.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
920 ROLLING ACRES RD UNIT 203, Lady Lake, FL 32159
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Secondary Practice Location 1

Location 11340 Citizens BlvdLeesburg, FL 34748-3924 · Phone (352) 435-7695

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2048782

Johnny Gurgen Do PA · Leesburg, FL
Active · expires Jan 1, 2027
CLIA Number10D2048782
Laboratory TypePhysician Office
Certificate Effective DateJanuary 2, 2025
Certificate Expiration DateJanuary 1, 2027
Laboratory DirectorJohnny Gurgen
Laboratory Phone(352) 435-7695
Laboratory LocationJohnny Gurgen Do PA1340 Citizens Blvd, Leesburg, FL 34748
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2086122

Johnny Gurgen Do PA · Lady Lake, FL
Active · expires Jan 28, 2027
CLIA Number10D2086122
Laboratory TypePhysician Office
Certificate Effective DateJanuary 29, 2025
Certificate Expiration DateJanuary 28, 2027
Laboratory DirectorJohnny Gurgen
Laboratory Phone(352) 435-7695
Laboratory LocationJohnny Gurgen Do PA920 Rolling Acres Rd Suite 204, Lady Lake, FL 32159
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

MURAT MICHAEL GURGEN ARNP
Nurse Practitioner
920 ROLLING ACRES RD UNIT 203
LADY LAKE, FL 32159
Lake County (352) 435-7695
JOHNNY GURGEN D.O.
Dermatology
920 ROLLING ACRES RD UNIT 203
LADY LAKE, FL 32159
Lake County (352) 435-7695

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 Johnny Gurgen Do PA's NPI number?

The NPI number for Johnny Gurgen Do PA is 1770856833. It was assigned to this organization in the NPPES registry on February 20, 2012.

Where is Johnny Gurgen Do PA located?

Johnny Gurgen Do PA is located at 920 Rolling Acres Rd Unit 203, Lady Lake, FL 32159. The listed phone number is (352) 435-7695.

What is Johnny Gurgen Do PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Johnny Gurgen Do PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Johnny Gurgen Do PA was last updated on November 18, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.