NPIMap

Organization Active NPI

Dermatology Institute of Southwest Florida Inc

  • Dermatology Physician
  • Venice, FL
National Provider Identifier
1073578449
Registry record updated Jul 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
DERMATOLOGY INSTITUTE OF SOUTHWEST FLORIDA INC
Practice address
1415 E Venice Ave
Venice, FL 34292-3064
Phone
(941) 488-5300
Fax
(941) 412-1003
NPI assigned
Apr 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2012

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

Authorized official

Name
Dr. Adam S. Greenberg, M.D.
Title
Owner
Phone
(941) 488-5300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1415 E Venice Ave
Venice, FL 34292-3064

Mailing address

1415 E Venice Ave
Venice, FL 34292-3064
Phone (941) 488-5300

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343606400000",
    "number": "1073578449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E VENICE AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923064",
            "telephone_number": "941-488-5300",
            "fax_number": "941-412-1003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 E VENICE AVE",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342923064",
            "telephone_number": "941-488-5300",
            "fax_number": "941-412-1003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY INSTITUTE OF SOUTHWEST FLORIDA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-07-30",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "ADAM",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-488-5300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2012; 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.