Charles Perniciaro MD PA

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

Legal business name

CHARLES PERNICIARO MD PA

Doing business as

Neptune Beach Dermatology

Practice address

183 Landrum LN
Suite 201
Ponte Vedra Beach, FL 32082-3837

Phone

(904) 241-0633

NPI assigned

Jul 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Charles V. Perniciaro, M.D.NPI 1972557890

Title

Owner & Physician Provider

Phone

(904) 241-0633

Specialties & licenses 1

Addresses

Other names 1

• Neptune Beach Dermatology Doing business as

Locations

Practitioners 2

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

• Charles Vincent Perniciaro, M.D.

  • Dermatopathology Physician
  • Tampa, FL
  • NPI 1972557890
  NPD (past) Authorized official
• Judith E Baird, PA-C

  • Physician Assistant
  • Ponte Vedra Beach, FL
  • NPI 1598723793
  NPD (past)

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1407877392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51498",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322401498",
            "telephone_number": "904-246-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 LANDRUM LN",
            "address_2": "SUITE 201",
            "city": "PONTE VEDRA BEACH",
            "state": "FL",
            "postal_code": "320823837",
            "telephone_number": "904-241-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES PERNICIARO MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-23",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "PERNICIARO",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "OWNER & PHYSICIAN PROVIDER",
        "authorized_official_telephone_number": "904-241-0633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neptune Beach Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shirley Casillas
• Claire Castellano, LPC
• Clayton Christopher Celander, DMD
• Stephanie Michelle Ceparano
• Adam I. Chaifetz, D.C.
• Charles V Perniciaro, M.D., P.C., D/B/a Brunswick Dermatology Clinic (Brunswick Dermatology Clinic)
• Christian Counseling Associates of Jacksonville
• Chae Hyung Chung
• Lauren Church
• Jessica Marie Clark, APRN

• Dermatopathology Physician in Ponte Vedra Beach, FL
• Providers in Ponte Vedra Beach, FL by specialty
• Dermatopathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.