Eastside Dermatology, PA

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800002278 Issued in FL

Legal business name

EASTSIDE DERMATOLOGY, PA

Practice address

5353 N Federal Hwy
Suite 400
Fort Lauderdale, FL 33308-3245

Phone

(954) 489-9800

Fax

(954) 489-0401

NPI assigned

Oct 28, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Igor Chaplik, D.O.

Title

President

Phone

(954) 489-9800

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jason Green, DO

  • Dermatology Physician
  • Fort Lauderdale, FL
  • NPI 1427167261
  NPD

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

{
    "created_epoch": "1288224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288224000000",
    "number": "1477853125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 N FEDERAL HWY",
            "address_2": "SUITE 400",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083245",
            "telephone_number": "954-489-9800",
            "fax_number": "954-489-0401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 N FEDERAL HWY",
            "address_2": "SUITE 400",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333083245",
            "telephone_number": "954-489-9800",
            "fax_number": "954-489-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTSIDE DERMATOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-28",
        "last_updated": "2010-10-28",
        "status": "A",
        "authorized_official_last_name": "CHAPLIK",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-489-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800002278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Ft Lauderdale LLC
• East Las Olas Psychological Group
• East Las Olas Psychological Group
• East/West Pediatrics, P.a.
• Eastern Acupuncture Fort Lauderdale
• Eastside Surgical Services, Inc.
• Easy Reach Pain & Integrated Wellness, LLC
• Easy Reach Physical Therapy & Rehab Inc
• Easyhealth Clinic LLC
• Shanique Ebanks

• Clinical Medical Laboratory in Fort Lauderdale, FL
• Providers in Fort Lauderdale, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; 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.