NPIMap

Organization Active NPI

Shino Bay Cosmetic Dermatology & Laser Institute LLC

  • Dermatology Physician
  • Fort Lauderdale, FL
National Provider Identifier
1164690582
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
SHINO BAY COSMETIC DERMATOLOGY & LASER INSTITUTE LLC
Practice address
350 E Las Olas Blvd
Suite 110
Ft Lauderdale, FL 33301-4211
Phone
(954) 765-3005
NPI assigned
Feb 19, 2008
Last updated
Sep 8, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Authorized official

Name
Shino B Aguilera, DONPI 1316992514
Title
Owner
Phone
(954) 765-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

350 E Las Olas Blvd
Suite 110
Ft Lauderdale, FL 33301-4211

Mailing address

350 E Las Olas Blvd
Suite 110
Ft Lauderdale, FL 33301-4211
Phone (954) 765-3005

National Provider Directory

National Provider Directory

Locations

350 E Las Olas Blvd
Ste 110
Ft Lauderdale, FL 33301
Phone (954) 765-3005

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1164690582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 E LAS OLAS BLVD",
            "address_2": "SUITE 110",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333014211",
            "telephone_number": "954-765-3005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 E LAS OLAS BLVD",
            "address_2": "SUITE 110",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333014211",
            "telephone_number": "954-765-3005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHINO BAY COSMETIC DERMATOLOGY & LASER INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "AGUILERA",
        "authorized_official_first_name": "SHINO",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-765-3005",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2008; 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.