Active NPI
Danielle Nicolazzo, D.O.
- Dermatology Physician
- Doral, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- OS13471
- 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, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| QTLW6 | Other | FL | BC/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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
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
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 106 |
| Skin biopsy | 28 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| UO4275 | FL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dermatology Group of Florida, P.a. | Dermatology | Current | 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
- 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.
-
- Dermatology Physician
- South Miami, FL
- NPI 1497806459
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.