NPIMap

Organization Active NPI

Premier Dermatology, LLC

Doing business as pennie dermatology & skin surgery center, llc

  • Dermatology Physician
  • Englewood, FL
National Provider Identifier
1417357922
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
PREMIER DERMATOLOGY, LLC
Doing business as
pennie dermatology & skin surgery center, llc
Practice address
900 Pine Street 122 / 123
Englewood, FL 34233-0000
Phone
(941) 474-8811
NPI assigned
Sep 3, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Authorized official

Name
Michael Franks
Title
Coo
Phone
(954) 333-8887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

900 Pine Street 122 / 123
Englewood, FL 34233-0000

Mailing address

3328 Bee Ridge Rd
Sarasota, FL 34239-7213
Phone (941) 474-8811

Other names 1

  • pennie dermatology & skin surgery center, llc Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Abrams Dermatology LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3328 Bee Ridge Rd
Sarasota, FL 34239
Phone (941) 923-2600

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411689600000",
    "number": "1417357922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3328 BEE RIDGE RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342397213",
            "telephone_number": "941-474-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PINE STREET 122 / 123",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342330000",
            "telephone_number": "941-474-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-09-26",
        "status": "A",
        "authorized_official_last_name": "FRANKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-333-8887"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pennie dermatology & skin surgery center, llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Englewood, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.