Complete Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

COMPLETE DERMATOLOGY LLC

Practice address

21550 Biscayne Blvd Ste 131
Aventura, FL 33180-1258

Phone

(305) 814-3376

Fax

(305) 939-5928

NPI assigned

Apr 7, 2023

Last updated

Apr 7, 2023By 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

Dan Ilkovitch, MDNPI 1447512827

Title

Provider

Phone

(240) 354-6931

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dan Ilkovitch, MD, PHD

  • Dermatology Physician
  • Aventura, FL
  • NPI 1447512827
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1680825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680825600000",
    "number": "1588359293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21550 BISCAYNE BLVD STE 131",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801258",
            "telephone_number": "305-814-3376",
            "fax_number": "305-939-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21550 BISCAYNE BLVD STE 131",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801258",
            "telephone_number": "305-814-3376",
            "fax_number": "305-939-5928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-07",
        "last_updated": "2023-04-07",
        "certification_date": "2023-04-07",
        "status": "A",
        "authorized_official_last_name": "ILKOVITCH",
        "authorized_official_first_name": "DAN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "240-354-6931",
        "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 Aventura, FL
• Providers in Aventura, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.