Ridge-Edwards Dermatology PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

RIDGE-EDWARDS DERMATOLOGY PA

Practice address

1754 E Commercial Blvd
Oakland Park, FL 33334-5721

Phone

(954) 776-5463

Fax

(954) 776-5466

NPI assigned

May 8, 2007

Last updated

Oct 9, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Edward K Edwards Jr., MD

Title

Owner

Phone

(954) 941-5401

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1447463005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1754 E COMMERCIAL BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333345721",
            "telephone_number": "954-776-5463",
            "fax_number": "954-776-5466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1754 E COMMERCIAL BLVD",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333345721",
            "telephone_number": "954-776-5463",
            "fax_number": "954-776-5466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 N Federal Hwy",
            "address_2": "SUITE 106",
            "address_purpose": "LOCATION",
            "city": "Pompano Beach",
            "state": "FL",
            "postal_code": "330621034",
            "country_code": "US",
            "telephone_number": "954-941-5401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RIDGE-EDWARDS DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "954-941-5401",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Oakland Park, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.