Jennifer Moscoso Conde, D.O.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS12902 Issued in FL

Practice address

5627 Skyop Drive
Lithia, FL 33547

Phone

(813) 530-6511

NPI assigned

Jun 29, 2014

Last updated

Mar 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Jennifer Marie Moscoso Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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.

• Conde Dermatology Group PLLC

  dba Comprehensive Center for Dermatology

  • Clinic/Center
  • Lithia, FL
  • NPI 1588195721
  Authorized official Same address or phone

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

{
    "created_epoch": "1404000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710547200000",
    "number": "1578978516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5627 SKYTOP DR",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "335474165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5627 SKYOP DRIVE",
            "city": "LITHIA",
            "state": "FL",
            "postal_code": "33547",
            "telephone_number": "813-530-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONDE",
        "first_name": "JENNIFER",
        "middle_name": "MOSCOSO",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-29",
        "last_updated": "2024-03-16",
        "certification_date": "2024-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS12902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IZ758Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MOSCOSO",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nina Lynn Coletta, ATC, LAT
• Yvette Marie Collins
• Comfortable Care Dental Health Professionals, P.a. (Dental Care at FishHawk Commons)
• Comfortable Care Dental Health Professionals, P.a. (Bayberry Dental)
• Conde Dermatology Group PLLC (Comprehensive Center for Dermatology)
• Meghan Cosano
• Count on Care LLC
• Pamela Joy Coyner-Bruno, R.N.
• Barry L Creighton, D.P.M.
• Aliyah Crite

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.