Fort Myers Dermatopathology

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

FORT MYERS DERMATOPATHOLOGY

Practice address

4901 Palm Beach Blvd
Suite 12
Fort Myers, FL 33905-3252

Phone

(239) 274-0005

Fax

(239) 278-4718

NPI assigned

May 11, 2007

Organization subpart

No

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

Authorized official

Name

Mazen Daoud, MDNPI 1316903560

Title

President

Phone

(239) 274-0005

Specialties & licenses 1

Addresses

Tax ID family

Fort Myers Dermatopathology4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

• Fort Myers Dermatopathology

  • Procedural Dermatology Physician
  • Cape Coral, FL
  • NPI 1215142567
  NPD tax ID
• Fort Myers Dermatopathology

  • Procedural Dermatology Physician
  • Estero, FL
  • NPI 1366657629
  NPD tax ID
• Fort Myers Dermatopathology

  • Procedural Dermatology Physician
  • Bonita Springs, FL
  • NPI 1831304500
  NPD tax ID

Locations

Practitioners 1

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

• Mazen Daoud, MD

  • Dermatopathology Physician
  • Fort Myers, FL
  • NPI 1316903560
  NPD (past) Authorized official

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083829337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8381 RIVERWALK PARK BLVD",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339198760",
            "telephone_number": "239-274-0005",
            "fax_number": "239-278-4718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 PALM BEACH BLVD",
            "address_2": "SUITE 12",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339053252",
            "telephone_number": "239-274-0005",
            "fax_number": "239-278-4718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORT MYERS DERMATOPATHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DAOUD",
        "authorized_official_first_name": "MAZEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-274-0005",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fort Myers Centre for Facial Plastic and Laser Surgery, Inc.
• Fort Myers Children'S Surgery Center, LLC
• Fort Myers Chiropractic & Nutrition Center, Inc.
• Fort Myers Chiropractic Studio LLC
• Fort Myers Dental Arts
• Fort Myers Dermatopathology PA
• Fort Myers Endoscopy Center LLC
• Fort Myers Eye Associates PA
• Fort Myers Eye Center Inc
• Fort Myers Eye Surgery Center LLC

• Procedural Dermatology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.