Premier Dermatology, MD, LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

ME100331 Issued in FL

Legal business name

PREMIER DERMATOLOGY, MD, LLC

Practice address

21097 NE 27TH CT
Ste 500
Aventura, FL 33180-1204

Phone

(305) 931-6661

NPI assigned

Nov 1, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Donna Bilu Martin, MDNPI 1164565321

Title

Owner

Phone

(305) 335-5423

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Premier Dermatology MD LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Premier Dermatology, MD, LLC

  • Dermatology Physician
  • Aventura, FL
  • NPI 1578955811
  NPD tax ID

Locations

Practitioners 2

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

• Donna Bilu Martin, M.D.

  • Dermatology Physician
  • Aventura, FL
  • NPI 1164565321
  Medicare reassignment Care Compare group NPD Authorized official
• Catherine Balestra

  • Dermatology Physician
  • Miramar, FL
  • NPI 1518177013
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1414800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414800000000",
    "number": "1285039248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20790 NE 32ND AVE",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331803646",
            "telephone_number": "305-335-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT",
            "address_2": "STE 500",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801204",
            "telephone_number": "305-931-6661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-01",
        "last_updated": "2014-11-01",
        "status": "A",
        "authorized_official_last_name": "BILU MARTIN",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-335-5423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME100331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jyoti Pradhananga, MD
• Michael R Preciados, DPT
• Precision OBGYN -FL PA
• Preferred Physical Therapy Associates, Inc.
• Preferred Psych LLC
• Premier Dermatology, MD, LLC
• Premier Florida Podiatry, PA
• Juan Premoli, M.D.
• Ruth Claire Prevor, PH.D.,ABPP
• Primary Care Physicians of Hollywood PL

• Medical Specialty Clinic/Center in Aventura, FL
• Providers in Aventura, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2014; 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.