Organization Active NPI

Florida Advanced Medical and Derm Aesthetics LLC

  • Family Medicine Physician
  • Delray Beach, FL
National Provider Identifier
1174899082
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLORIDA ADVANCED MEDICAL AND DERM AESTHETICS LLC
Practice address
13660 S Jog Rd Ste 1B
Delray Beach, FL 33446-3806
Phone
(561) 499-6622
Fax
(561) 499-6795
NPI assigned
Mar 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Authorized official

Name
Dr. Anjan Patel, M.D.NPI 1255645156
Title
Manager
Phone
(215) 435-8011

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

13660 S Jog Rd Ste 1B
Delray Beach, FL 33446-3806

Mailing address

13660 S Jog Rd Ste 1B
Delray Beach, FL 33446-3806
Phone (561) 499-6622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130409000335 FL Part B Supplier - Clinic/Group Practice 4385880798 Receives reassigned benefits from 4 practitioners
Practice locations: Boca Raton, FL; Delray Beach, FL

National Provider Directory

National Provider Directory

Locations

5030 Champion Blvd
Ste G5
Boca Raton, FL 33496
Phone (561) 994-7358

13660 S Jog Rd
Ste 1B
Delray Beach, FL 33446
Phone (561) 499-6622

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1332633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739491200000",
    "number": "1174899082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13660 S JOG RD STE 1B",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334463806",
            "telephone_number": "561-499-6622",
            "fax_number": "561-499-6795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13660 S JOG RD STE 1B",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334463806",
            "telephone_number": "561-499-6622",
            "fax_number": "561-499-6795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA ADVANCED MEDICAL AND DERM AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-25",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANJAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "215-435-8011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.