Venice Dermatology Clinic PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME69164 Issued in FL

Legal business name

VENICE DERMATOLOGY CLINIC PA

Practice address

716 The Rialto
Venice, FL 34285-3524

Phone

(941) 484-2250

Fax

(941) 484-9638

NPI assigned

Aug 7, 2007

Last updated

Oct 4, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bruce A Boyd, MDNPI 1750491494

Title

Owner

Phone

(941) 484-2250

Specialties & licenses 1

Addresses

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Venice Dermatology Clinic PA

  dba Reviance Dermatology

  • Dermatopathology Physician
  • North Port, FL
  • NPI 1801369020
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bruce Allen Boyd, MD

  • Dermatology Physician
  • Venice, FL
  • NPI 1750491494
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317686400000",
    "number": "1003007840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853524",
            "telephone_number": "941-484-2250",
            "fax_number": "941-484-9638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 THE RIALTO",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342853524",
            "telephone_number": "941-484-2250",
            "fax_number": "941-484-9638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENICE DERMATOLOGY CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-07",
        "last_updated": "2011-10-04",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-484-2250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME69164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Venice Assisted Living Facility, LLC (AdviniaCare at Venice)
• Venice Cardiovascular Anesthesia Associates PLLC
• Venice Cardiovascular Associates PL
• Venice Counseling PLLC
• Venice Dental Care, PA
• Venice Emergency Medical Associates
• Venice Emergency Medical Associates PA
• Venice Emergency Medical Associates PA
• Venice Eye Care Inc.
• Venice FL Opco LLC (Orchid Cove at Venice)

• Dermatology Physician in Venice, FL
• Providers in Venice, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.