Water's Edge Dermatology

Primary specialty

Procedural Dermatology PhysicianTaxonomy code 207NS0135X

Legal business name

WATER'S EDGE DERMATOLOGY

Practice address

7605 Conroy Windermere Rd
Orlando, FL 32835-2646

Phone

(561) 693-0540

Fax

(561) 422-4212

NPI assigned

Jul 20, 2016

Last updated

Jul 20, 2016By 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

Amanda Mitchell

Title

Billing Director

Phone

(561) 693-0540

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1477906857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2845 PGA BLVD",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102910",
            "telephone_number": "561-693-0540",
            "fax_number": "561-422-4212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7605 CONROY WINDERMERE RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328352646",
            "telephone_number": "561-693-0540",
            "fax_number": "561-422-4212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER'S EDGE DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "561-693-0540"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "",
            "desc": "Dermatology, Dermatopathology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wasserman Pediatrics, P.a.
• Lewis Wasserman, MD
• Sharon M Wasserstrom, MD
• Christopher William Wasyliw, MD
• Pankaj Watal, M.D.
• Waterbridge Dental Group, P.a
• Waterford Chase Dental
• Waterford Dental Associates
• Waterford Lakes Wellness and Injury Inc
• Waterford Lakes Women's Health Center

• Procedural Dermatology Physician in Orlando, FL
• Providers in Orlando, FL by specialty
• Procedural Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.