Prestige Dermatology Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS7718 Issued in FL

Legal business name

PRESTIGE DERMATOLOGY INC

Practice address

5091 Little Road
New Port Richey, FL 34655

Phone

(727) 849-1447

Fax

(727) 849-3208

NPI assigned

Jun 6, 2007

Organization subpart

No

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

Authorized official

Name

Natalie L Monticciolo, DO

Title

Provider

Phone

(727) 849-1447

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569888000000",
    "number": "1205039682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5091 LITTLE ROAD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-849-1447",
            "fax_number": "727-849-3208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5091 LITTLE ROAD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "34655",
            "telephone_number": "727-849-1447",
            "fax_number": "727-849-3208"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4546 Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "New Port Richey",
            "state": "FL",
            "postal_code": "346525119",
            "country_code": "US",
            "telephone_number": "727-849-1447",
            "fax_number": "727-849-3208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRESTIGE DERMATOLOGY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2019-10-01",
        "status": "A",
        "authorized_official_last_name": "MONTICCIOLO",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "727-849-1447",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS7718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in New Port Richey, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2019; 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.