Dermatology Group PA

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DERMATOLOGY GROUP PA

Practice address

2850 Morningside Dr
Mount Dora, FL 32757-6610

Phone

(352) 383-0733

Fax

(352) 383-7112

NPI assigned

Mar 21, 2006

Last updated

Jul 26, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Erin Howard

Title

Administrator

Phone

(407) 332-8080

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 19

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.

• Hana Nasim Ahmed, MD

  • Dermatopathology Physician
  • Mount Dora, FL
  • NPI 1134682685
  Medicare reassignment Care Compare group NPD
• Saqib Ahmed, M.D.

  • MOHS-Micrographic Surgery Physician
  • Longwood, FL
  • NPI 1801214721
  Medicare reassignment Care Compare group NPD
• Robert W Demetrius, MD

  • Procedural Dermatology Physician
  • Mount Dora, FL
  • NPI 1386603009
  Medicare reassignment Care Compare group NPD
• Alfredo E Gonzalez, M.D.

  • Dermatology Physician
  • Winter Park, FL
  • NPI 1659402840
  Medicare reassignment Care Compare group NPD
• Jeffrey S. Greenwald, M.D.

  • Dermatology Physician
  • Mount Dora, FL
  • NPI 1679532923

  Specialist

  Medicare reassignment Care Compare group NPD
• Michael S. Henner, M.D.

  • Dermatopathology Physician
  • Mount Dora, FL
  • NPI 1396704649

  Specialist

  Medicare reassignment Care Compare group NPD
• Melia Hernandez Holt, M.D.

  • Dermatology Physician
  • Longwood, FL
  • NPI 1902284177

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Kemka S Ogburia Jr., MD

  • MOHS-Micrographic Surgery Physician
  • Longwood, FL
  • NPI 1275710758

  Specialist

  Medicare reassignment Care Compare group NPD
• Kathleen B Zendell, MD

  • Dermatology Physician
  • Longwood, FL
  • NPI 1457586547
  Medicare reassignment Care Compare group NPD
• Michelle Thomas Snider, PA-C

  • Dermatology Physician
  • The Villages, FL
  • NPI 1891805149
  Medicare reassignment Care Compare group
• Ashley R Vrecenak, P.A.

  • Medical Physician Assistant
  • Longwood, FL
  • NPI 1639496565
  Medicare reassignment Care Compare group
• George Dimitrios Papanicolaou, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Lake Mary, FL
  • NPI 1982895223
  Medicare reassignment NPD

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690329600000",
    "number": "1356300081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 W SR 434 STE 210",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327505162",
            "telephone_number": "407-332-8080",
            "fax_number": "352-383-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 MORNINGSIDE DR",
            "city": "MOUNT DORA",
            "state": "FL",
            "postal_code": "327576610",
            "telephone_number": "352-383-0733",
            "fax_number": "352-383-7112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2304 Aloma Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923330",
            "country_code": "US",
            "telephone_number": "407-332-8080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 N Lakemont Ave Ste 800",
            "address_purpose": "LOCATION",
            "city": "Winter Park",
            "state": "FL",
            "postal_code": "327923200",
            "country_code": "US",
            "telephone_number": "407-645-2737",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 E Hazel St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328044023",
            "country_code": "US",
            "telephone_number": "407-898-3033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY GROUP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-21",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "407-332-8080",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonas McDonald Deffes
• Crystal Dejesus, PA-C
• Ruben Del Toro
• Jasmine M Demarco
• Robert W Demetrius, MD
• Marie Derozin, RBT
• Purvi Desai, DO
• Widdler Deshommes, MD
• Aliyyah Dewji
• Haleigh Dhaiti

• Specialist in Mount Dora, FL
• Providers in Mount Dora, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.