Laura Destefano, DO

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS 10179 Issued in FL

Practice address

2489 Diplomat Pkwy E
Cape Coral, FL 33909-5422

Phone

(239) 652-1800

Fax

(239) 652-1930

NPI assigned

Dec 21, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Water'S Edge Dermatology, LLC

  • Dermatology Physician
  • Palm Beach Gardens, FL
  • NPI 1134148992
  Medicare reassignment NPD
• Water'S Edge Dermatology, LLC

  • Clinical Medical Laboratory
  • Palm Beach Gardens, FL
  • NPI 1871542787
  NPD
• Ioannides and Sanders Dermatology Associates LLC

  • Dermatology Physician
  • Port St Lucie, FL
  • NPI 1669653473
  NPD (past)
• Orbital and Oculo Facial Consultants, P.a.

  • Plastic and Reconstructive Surgery Physician
  • Sarasota, FL
  • NPI 1619286267
  NPD (past)
• Orbital and Oculo Facial Consultants, PA

  • Plastic and Reconstructive Surgery Physician
  • Sarasota, FL
  • NPI 1407057805
  NPD (past)

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

{
    "created_epoch": "1261353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647302400000",
    "number": "1003145087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800",
            "fax_number": "239-652-1930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2489 DIPLOMAT PKWY E",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095422",
            "telephone_number": "239-652-1800",
            "fax_number": "239-652-1930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "LAURA",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-21",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS 10179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sudhanshu Balwantrai Desai, DDS
• Kristy Marie Desjardin, C.O.T.A/L
• Desmond J Smith
• Desmornes, Joseph
• Karen Desouza Ferreira Hunt
• Joseph Desulme, FNP-C
• Kettely Devariste
• Devereux Foundation
• Arianna Devesa Navarro
• Deborah Ann Devlin, LCSW

• Dermatology Physician in Cape Coral, FL
• Providers in Cape Coral, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.