NPIMap

Organization Active NPI

Ioannides and Sanders Dermatology Associates LLC

  • Dermatology Physician
  • Port St Lucie, FL
National Provider Identifier
1669653473
Registry record updated Nov 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
IOANNIDES AND SANDERS DERMATOLOGY ASSOCIATES LLC
Practice address
140 SW Chamber CT
200
Port St Lucie, FL 34986-3414
Phone
(772) 878-3376
Fax
(772) 879-9970
NPI assigned
Nov 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2007

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

Authorized official

Name
Dr. Tim Ioannides, MDNPI 1952369779
Title
Partner
Phone
(772) 878-3376

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 Primary

Addresses

Primary practice location

140 SW Chamber CT
200
Port St Lucie, FL 34986-3414

Mailing address

140 SW Chamber CT
200
Port St Lucie, FL 34986-3414
Phone (772) 878-3376

Other names 1

  • Treasure Coast Dermatology Doing business as

National Provider Directory

National Provider Directory

Locations

140 SW Chamber Ct
Ste 200
Port St Lucie, FL 34986
Phone (772) 878-3376

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1669653473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "200",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863414",
            "telephone_number": "772-878-3376",
            "fax_number": "772-879-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 SW CHAMBER CT",
            "address_2": "200",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349863414",
            "telephone_number": "772-878-3376",
            "fax_number": "772-879-9970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IOANNIDES AND SANDERS DERMATOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-20",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "IOANNIDES",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "772-878-3376",
        "authorized_official_name_prefix": "Dr.",
        "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": [
        {
            "organization_name": "Treasure Coast Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port St Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.