Florida Institute of Dermatology LLC

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

FLORIDA INSTITUTE OF DERMATOLOGY LLC

Practice address

1991 Daniels Rd
Winter Garden, FL 34787

Phone

(407) 395-3770

Fax

(407) 395-3779

NPI assigned

May 6, 2019

Organization subpart

No

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

Authorized official

Name

Michael Waudo Wangia, MDNPI 1548495955

Title

Medical Director

Phone

(352) 246-3254

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 7

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

• Michael Waudo Wangia, MD

  • Dermatology Physician
  • Winter Garden, FL
  • NPI 1548495955
  Medicare reassignment Care Compare group NPD Authorized official
• Evan Paige Chastain, ARNP

  • Nurse Practitioner
  • Winter Garden, FL
  • NPI 1427291509
  Medicare reassignment Care Compare group NPD
• Joanna Hoffman, ARNP

  • Adult Health Nurse Practitioner
  • Winter Garden, FL
  • NPI 1043754492
  Medicare reassignment Care Compare group NPD
• Melanie Williams, DO

  • Dermatology Physician
  • Winter Garden, FL
  • NPI 1316406168
  Medicare reassignment Care Compare group NPD
• Wallace Ramsey Nozile, MD

  • Dermatology Physician
  • Washington, DC
  • NPI 1093101107

  FL

  Medicare reassignment Care Compare group NPD
• Brianna Lynn Gonzalez

  • Physician Assistant
  • Winter Garden, FL
  • NPI 1528527884
  Medicare reassignment Care Compare group
• Eric Michaelis-Woodard

  • Physician Assistant
  • Orlando, FL
  • NPI 1255709283
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1356906358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10747 EMERALD CHASE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365876",
            "telephone_number": "352-246-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1991 DANIELS RD",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "34787",
            "telephone_number": "407-395-3770",
            "fax_number": "407-395-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA INSTITUTE OF DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-06",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "WANGIA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAUDO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-246-3254",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melanie Fleming, APRN
• Scott Alexander Fleming, MDIV, MS, NCC, HEC-C
• Lideyni J Flores, RN
• Florida Care Center Winter Garden, LLC
• Florida Hospital Medical Group Inc
• Florida Primary Care Center, PA
• Florida Radiology Imaging at Lake Mary LLC
• Florida Woman Care ,LLC
• Florida Woman Care LLC
• Florida Woman Care, LLC

• Dermatopathology Physician in Winter Garden, FL
• Providers in Winter Garden, FL by specialty
• Dermatopathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.