Dermatology Clinic, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

78997 Issued in FL

Legal business name

DERMATOLOGY CLINIC, PA

Practice address

880 NW 13TH St
Suite 3B
Boca Raton, FL 33486-2342

Phone

(561) 393-0300

Fax

(561) 393-0048

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stella D Calobrisi, M.D.NPI 1891717898

Title

Director

Phone

(561) 393-0300

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

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

• Stella Divina Calobrisi, M.D.

  • Specialist
  • Boca Raton, FL
  • NPI 1891717898
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1295890853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST",
            "address_2": "SUITE 3B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-393-0300",
            "fax_number": "561-393-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 NW 13TH ST",
            "address_2": "SUITE 3B",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334862342",
            "telephone_number": "561-393-0300",
            "fax_number": "561-393-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "CALOBRISI",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "561-393-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "78997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL NUMBER",
            "identifier": "1891717898",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BLUE SHIELD NUMBER",
            "identifier": "49480",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PENN NUMBER",
            "identifier": "115370",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "49480Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE NUMBER",
            "identifier": "78997",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leaanne Derigne, MSW, PHD
• Francescar Derisier
• Erica Derkits, CRNP
• Jamisyn Danielle Derks
• Stephen Peter Dermarkarian
• Dermatology Group of Florida PA
• Dermatology of Boca LLC
• Dermpartners Inc
• Dermpath Lab LLC
• Dero Pain Specialists LLC

• Specialist in Boca Raton, FL
• Providers in Boca Raton, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.