Dermatology and Skin Surgery Center, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME0058612 Issued in FL

Legal business name

DERMATOLOGY AND SKIN SURGERY CENTER, PA

Practice address

410 Celebration PL
Suite 301
Celebration, FL 34747-5433

Phone

(407) 566-1616

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dean R Goodless, MD

Title

President

Phone

(407) 566-1616

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477640902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "SUITE 301",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "407-566-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CELEBRATION PL",
            "address_2": "SUITE 301",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347475433",
            "telephone_number": "407-566-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN SURGERY CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOODLESS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "407-566-1616",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0058612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Massiel Decamps, PSY.D.
• Elizabeth King Decker, MA, LMFT
• Maria Alessandra Dejorge, APRN
• Dental Anesthesia Services LLC
• Nicole Gilmore Derda, AU.D.
• Anjali Desai
• Mary Virginia Desario, APRN
• Jason Descalso, PA
• Marie Lourdes Desir, APRN
• Dinah Jane Diao, M.A., CCC-SLP

• Dermatology Physician in Celebration, FL
• Providers in Celebration, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.