Lauderdale Dermatology PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

ME0068188 Issued in FL

Legal business name

LAUDERDALE DERMATOLOGY PA

Practice address

4610 North Federal Highway
Ft Lauderdale, FL 33308

Phone

(954) 771-0582

Fax

(954) 771-6465

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Gregory L Perez, MD

Title

President

Phone

(954) 771-0582

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750474615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 NORTH FEDERAL HIGHWAY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-771-0582",
            "fax_number": "954-771-6465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 NORTH FEDERAL HIGHWAY",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "33308",
            "telephone_number": "954-771-0582",
            "fax_number": "954-771-6465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUDERDALE DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-771-0582",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME0068188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trent Lau, MD
• Karina Grace Lauciello, DNP, APRN, CRNA
• Lauderdale Chiromed Centers, Inc
• Lauderdale Chiropractic Center Inc
• Lauderdale Dental and Implant Center, PLLC
• Lauderdale Health and Wellness Inc.
• Lauderdale Nursing Center LLC
• Lauderdale Orthopaedic Surgeons LLP
• Lauderdale Sports Performance Institute, PLLC
• Laura Cohen PA

• Dermatology Physician in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.