Individual provider Active NPI

Danielle Nicolazzo, D.O.

  • Dermatology Physician
  • Doral, FL
National Provider Identifier
1417362203
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
OS13471 Issued in FL
Practice address
3470 NW 82ND Ave Ste 111
Doral, FL 33122-1026
Phone
(786) 272-2500
Fax
(786) 272-2550
NPI assigned
Jun 30, 2014
Last updated
Jan 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X UO4275 FL
Dermatology Physician 207N00000X OS13471 FL Primary

Addresses

Primary practice location

3470 NW 82ND Ave Ste 111
Doral, FL 33122-1026

Mailing address

7031 SW 62ND Ave
South Miami, FL 33143-4701

Other practice location 1

7031 SW 62nd Ave
South Miami, FL 33143-4701
Phone (305) 284-7761

Other practice location 2

4308 Alton Rd Ste 750
Miami Beach, FL 33140-4557
Phone (305) 532-4478

Other identifiers 1

IdentifierTypeStateIssuer
QTLW6OtherFLBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181128001538 FL Practitioner - Dermatology 7315281698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Group of Florida, P.a.Group PAC ID 1153367107, 54 clinicians

Practice addresses (Care Compare)

836 Ponce de Leon Blvd
Suite 204
Coral Gables, FL 33134-3068
Phone (305) 324-2110

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions106
Skin biopsy28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
UO4275FLMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Group of Florida, P.a. Dermatology CurrentSince Jul 30, 2018 Accepting new patients

Locations

836 Ponce de Leon Blvd
Ste 204
Coral Gables, FL 33134
Phone (305) 261-0001

3470 NW 82nd Ave
Ste 111
Doral, FL 33122
Phone (786) 272-2500

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

4308 Alton Rd
Ste 750
Miami Beach, FL 33140
Phone (305) 324-2110

7031 SW 62nd Ave
South Miami, FL 33143
Phone (305) 284-7585

Interoperability endpoints

  • Direct secure messaging: dnicolazzo@dcm.emadirect.md

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1417362203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 SW 62ND AVE",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3470 NW 82ND AVE STE 111",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221026",
            "telephone_number": "786-272-2500",
            "fax_number": "786-272-2550"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7031 SW 62nd Ave",
            "address_purpose": "LOCATION",
            "city": "South Miami",
            "state": "FL",
            "postal_code": "331434701",
            "country_code": "US",
            "telephone_number": "305-284-7761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4308 Alton Rd Ste 750",
            "address_purpose": "LOCATION",
            "city": "Miami Beach",
            "state": "FL",
            "postal_code": "331404557",
            "country_code": "US",
            "telephone_number": "305-532-4478",
            "fax_number": "305-532-9753",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICOLAZZO",
        "first_name": "DANIELLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-30",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "UO4275",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS13471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "QTLW6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.