NPIMap

Organization Active NPI

Bracciano Dermatology PLC

  • MOHS-Micrographic Surgery Physician
  • University Park, FL
National Provider Identifier
1053362764
Registry record updated Oct 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
OS7345 Issued in FL
Legal business name
BRACCIANO DERMATOLOGY PLC
Practice address
8430 Cooper Creek Blvd
Suite 102
University Park, FL 34201
Phone
(941) 360-2255
Fax
(941) 487-1777
NPI assigned
May 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2011

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

Authorized official

Name
Dr. David Michael Bracciano Sr., DO
Title
Physician Owner
Phone
(941) 360-2255

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X OS7345 FL Primary

Addresses

Primary practice location

8430 Cooper Creek Blvd
Suite 102
University Park, FL 34201

Mailing address

6539 Flycatcher LN
Bradenton, FL 34202-8269
Phone (941) 360-2255

National Provider Directory

National Provider Directory

Locations

8243 Cooper Creek Blvd
University Park, FL 34201
Phone (941) 360-2255

8430 Cooper Creek Blvd
Ste 102
University Park, FL 34201
Phone (941) 360-2255

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318982400000",
    "number": "1053362764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6539 FLYCATCHER LN",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342028269",
            "telephone_number": "941-360-2255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8430 COOPER CREEK BLVD",
            "address_2": "SUITE 102",
            "city": "UNIVERSITY PARK",
            "state": "FL",
            "postal_code": "34201",
            "telephone_number": "941-360-2255",
            "fax_number": "941-487-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACCIANO DERMATOLOGY PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-10-19",
        "status": "A",
        "authorized_official_last_name": "BRACCIANO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "941-360-2255",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "OS7345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in University Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.