Organization Active NPI

Gold Coast Dermatology Center, PLLC

  • Dermatology Physician
  • Delray Beach, FL
National Provider Identifier
1104173905
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS10266 Issued in FL
Legal business name
GOLD COAST DERMATOLOGY CENTER, PLLC
Practice address
4600 Linton Blvd Ste 340
Delray Beach, FL 33445-6600
Phone
(561) 495-9797
Fax
(561) 499-9098
NPI assigned
Aug 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Authorized official

Name
Dr. Danielle Manolakos, DONPI 1760651921
Title
Ceo
Phone
(561) 495-9797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X OS10266 FL Primary

Addresses

Primary practice location

4600 Linton Blvd Ste 340
Delray Beach, FL 33445-6600

Mailing address

1000 Linton Blvd Ste A7
Delray Beach, FL 33444-1123
Phone (561) 272-0388

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1344556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1104173905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LINTON BLVD STE A7",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334441123",
            "telephone_number": "561-272-0388",
            "fax_number": "561-272-0498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 LINTON BLVD STE 340",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334456600",
            "telephone_number": "561-495-9797",
            "fax_number": "561-499-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST DERMATOLOGY CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-10",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "MANOLAKOS",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-495-9797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS10266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.