Dermagenesis Medspa, Inc.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

OS10159 Issued in FL

Legal business name

DERMAGENESIS MEDSPA, INC.

Practice address

2700 SW 194TH Ter
Miramar, FL 33029-2483

Phone

(305) 820-3377

Fax

(305) 820-3388

NPI assigned

May 7, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Louis Scheuermann, D.O.

Title

President/Medical Director

Phone

(305) 820-3377

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300492800000",
    "number": "1366618522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SW 194TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330292483",
            "telephone_number": "305-820-3377",
            "fax_number": "305-820-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SW 194TH TER",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330292483",
            "telephone_number": "305-820-3377",
            "fax_number": "305-820-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMAGENESIS MEDSPA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2011-03-19",
        "status": "A",
        "authorized_official_last_name": "SCHEUERMANN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "305-820-3377",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS10159",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS10159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Miramar, FL
• Providers in Miramar, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2011; 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.