Dermatology of Pompano LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY OF POMPANO LLC

Practice address

2040 E Sample Rd
Lighthouse Point, FL 33064-7596

Phone

(954) 960-5404

Fax

(754) 800-7174

NPI assigned

May 17, 2021

Last updated

Jul 18, 2022By 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

Mr. Edward Delgado Kozikowski

Title

President

Phone

(954) 960-5404

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

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.

• Leonard Slazinski, M. D.

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1942368915
  Medicare reassignment NPD
• Arnold R Oppenheim, M.D.

  • Dermatology Physician
  • Virginia Beach, VA
  • NPI 1649356940

  FL, Single Specialty

  Medicare reassignment NPD
• Gary Lee Waterman, D.O.

  • Dermatology Physician
  • Middletown, RI
  • NPI 1982632527

  FL

  Medicare reassignment NPD

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658102400000",
    "number": "1720652514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 E SAMPLE RD",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647596",
            "telephone_number": "954-960-5404",
            "fax_number": "754-800-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E SAMPLE RD",
            "city": "LIGHTHOUSE POINT",
            "state": "FL",
            "postal_code": "330647596",
            "telephone_number": "954-960-5404",
            "fax_number": "754-800-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY OF POMPANO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A",
        "authorized_official_last_name": "KOZIKOWSKI",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "DELGADO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-960-5404",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gisele R De Oliveira, DMD
• Donna Decunzo-Taddeo
• Jason Dela Cruz, DPT
• Christopher James Deleo, M.D.
• Dental & Sedation Group, LLC
• Mate Dezamits
• Dalila N Dias
• Andrea C Diaz Vasquez, D.M.D.
• Dr Hometown FTL LLC
• Dr JS Ocean Medical Center Inc

• Dermatology Physician in Lighthouse Point, FL
• Providers in Lighthouse Point, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.