Organization Active NPI

Resnik Dermatology Aventura, PA

  • Dermatology Physician
  • Aventura, FL
National Provider Identifier
1740409911
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
RESNIK DERMATOLOGY AVENTURA, PA
Practice address
21097 NE 27TH CT Ste 580
Aventura, FL 33180-1246
Phone
(305) 692-8998
Fax
(305) 692-8606
NPI assigned
Apr 25, 2007
Last updated
Jan 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Authorized official

Name
Dr. Barry I Resnik, M.D.NPI 1336148535
Title
Dermatologist
Phone
(305) 692-8998

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

21097 NE 27TH CT Ste 580
Aventura, FL 33180-1246

Mailing address

21097 NE 27TH CT Ste 580
Aventura, FL 33180-1246
Phone (305) 692-8998

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110908001944 FL Part B Supplier - Clinic/Group Practice 3375713985 Receives reassigned benefits from 2 practitioners
Practice locations: Aventura, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1009425Resnik Dermatology Aventura PA21097 NE 27TH CT, Ste 580, Aventura, FL 33180Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

2630 NE 203rd St
Ste 105
Miami, FL 33180
Phone (305) 692-8998

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675123200000",
    "number": "1740409911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT STE 580",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801246",
            "telephone_number": "305-692-8998",
            "fax_number": "305-692-8606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21097 NE 27TH CT STE 580",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801246",
            "telephone_number": "305-692-8998",
            "fax_number": "305-692-8606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESNIK DERMATOLOGY AVENTURA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A",
        "authorized_official_last_name": "RESNIK",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "305-692-8998",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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 Jan 31, 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.