Waters Edge Dermatology Global LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

WATERS EDGE DERMATOLOGY GLOBAL LLC

Practice address

2601 S Kanner Highway
Stuart, FL 34994

Phone

(561) 693-0540

NPI assigned

Sep 7, 2016

Organization subpart

No

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

Authorized official

Name

Theodore Schiff, MD

Title

Manager

Phone

(561) 693-0540

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1356898324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104543",
            "telephone_number": "561-693-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 S KANNER HIGHWAY",
            "city": "STUART",
            "state": "FL",
            "postal_code": "34994",
            "telephone_number": "561-693-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERS EDGE DERMATOLOGY GLOBAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "SCHIFF",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "561-693-0540",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zaria Washington
• Erica Wassuta, LMT
• Steven Matthew Wasylik Jr.
• Agnieszka Waszczuk Marshall, PSY D
• Stephanie Maelynn Waterman
• Waters Edge Recovery, LLC
• Waters Edge Surgery Center Inc
• Emily Elizabeth Watson
• Holly Watson
• Lindsay A. Watson

• Radiation Oncology Physician in Stuart, FL
• Providers in Stuart, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.