NPIMap

Organization Active NPI

Dermatology Consultants of S FL PA

  • Dermatology Physician
  • Coral Springs, FL
National Provider Identifier
1629186523
Registry record updated Nov 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MP36624 Issued in FL
Legal business name
DERMATOLOGY CONSULTANTS OF S FL PA
Practice address
3000 N University Dr
Suite K
Coral Springs, FL 33065-5055
Phone
(954) 752-2630
Fax
(954) 755-1865
NPI assigned
Aug 29, 2006
Reactivated
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2015

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

Authorized official

Name
Dr. Jeffrey J Kroll, MDNPI 1669435913
Title
MD
Phone
(954) 752-2630

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X MP36624 FL Primary

Addresses

Primary practice location

3000 N University Dr
Suite K
Coral Springs, FL 33065-5055

Mailing address

3000 N University Dr
Suite K
Coral Springs, FL 33065-5055
Phone (954) 752-2630

Other identifiers 1

IdentifierTypeStateIssuer
99554OtherFLMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

2929 N University Dr
Ste 101
Coral Springs, FL 33065
Phone (954) 752-2630

3000 N University Dr
Ste K
Coral Springs, FL 33065
Phone (954) 752-2630

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448582400000",
    "number": "1629186523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N UNIVERSITY DR",
            "address_2": "SUITE K",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655055",
            "telephone_number": "954-752-2630",
            "fax_number": "954-755-1865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N UNIVERSITY DR",
            "address_2": "SUITE K",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655055",
            "telephone_number": "954-752-2630",
            "fax_number": "954-755-1865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CONSULTANTS OF S FL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-29",
        "last_updated": "2015-11-27",
        "deactivation_date": "2007-01-30",
        "reactivation_date": "2007-02-26",
        "status": "A",
        "authorized_official_last_name": "KROLL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "954-752-2630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "MP36624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "99554",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2015; 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.