NPIMap

Organization Active NPI

Aventura Dermatology & Cosmetic Center

  • Dermatology Physician
  • Aventura, FL
National Provider Identifier
1669622452
Registry record updated Sep 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
AVENTURA DERMATOLOGY & COSMETIC CENTER
Practice address
21097 NE 27TH CT
Suite 500
Aventura, FL 33180-1204
Phone
(305) 931-6661
Fax
(305) 937-1733
NPI assigned
Sep 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2008

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

Authorized official

Name
Jason Green, DO
Title
Owner / President
Phone
(305) 931-6661

Specialties & licenses 1

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

Addresses

Primary practice location

21097 NE 27TH CT
Suite 500
Aventura, FL 33180-1204

Mailing address

21097 NE 27TH CT
Suite 500
Aventura, FL 33180-1204
Phone (305) 931-6661

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1222646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1669622452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT",
            "address_2": "SUITE 500",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801204",
            "telephone_number": "305-931-6661",
            "fax_number": "305-937-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT",
            "address_2": "SUITE 500",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801204",
            "telephone_number": "305-931-6661",
            "fax_number": "305-937-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVENTURA DERMATOLOGY & COSMETIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-29",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER / PRESIDENT",
        "authorized_official_telephone_number": "305-931-6661",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aventura, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; 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.