Brandon Dermatology P a

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

OS7868 Issued in FL

Legal business name

BRANDON DERMATOLOGY P A

Practice address

405 W Bloomingdale Ave
Brandon, FL 33511-7401

Phone

(813) 662-3376

Fax

(813) 662-3009

NPI assigned

Apr 3, 2007

Last updated

Sep 19, 2008By 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

Andres Tobon, D.O.NPI 1780799460

Title

Presidentphysician

Phone

(813) 662-3376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EICAAA

Practitioners 12

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.

• Andres Tobon, DO

  • Dermatology Physician
  • Brandon, FL
  • NPI 1780799460
  Medicare reassignment Care Compare group NPD Authorized official
• Sanjay Agarwal, DO

  • Dermatology Physician
  • Brandon, FL
  • NPI 1114548864
  Medicare reassignment Care Compare group NPD
• Ricardo Luis Berrios, M.D.

  • Dermatology Physician
  • Brandon, FL
  • NPI 1730348673
  Medicare reassignment Care Compare group NPD
• Jennifer Nicole Harb, M.D.

  • Dermatology Physician
  • Wesley Chapel, FL
  • NPI 1760879159
  Medicare reassignment Care Compare group NPD
• Ritika Bhandari, M.D.

  • Procedural Dermatology Physician
  • Jackson, MS
  • NPI 1831585256

  FL

  Medicare reassignment Care Compare group NPD
• David Christian Butson, PA

  • Physician Assistant
  • Lakeland, FL
  • NPI 1376831115
  Medicare reassignment Care Compare group
• Pia Marie Cooper, PA-C

  • Physician Assistant
  • Brandon, FL
  • NPI 1225502925
  Medicare reassignment Care Compare group
• Rachel Lauren Smith, PA-C

  • Physician Assistant
  • Brandon, FL
  • NPI 1528530698
  Medicare reassignment Care Compare group
• Alison Kyle Treesh, PA-C

  • Physician Assistant
  • Brandon, FL
  • NPI 1295918134
  Medicare reassignment Care Compare group
• Kendyl Baker

  • Physician Assistant
  • Brandon, FL
  • NPI 1104718113
  Medicare reassignment NPD
• Shannon Rachelle Carie, PA-C

  • Physician Assistant
  • Brandon, FL
  • NPI 1083968051
  Medicare reassignment
• Lexy Hazle, PA-C

  • Physician Assistant
  • Tampa, FL
  • NPI 1538780853
  Medicare reassignment

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221782400000",
    "number": "1760504682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117401",
            "telephone_number": "813-662-3376",
            "fax_number": "813-662-3009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 W BLOOMINGDALE AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335117401",
            "telephone_number": "813-662-3376",
            "fax_number": "813-662-3009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON DERMATOLOGY P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2008-09-19",
        "status": "A",
        "authorized_official_last_name": "TOBON",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "PRESIDENTPHYSICIAN",
        "authorized_official_telephone_number": "813-662-3376",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "OS7868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Comprehensive Dermatology
• Brandon Comprehensive Dermatology PA
• Brandon Cosmetic and Family Dentistry
• Brandon Dental Care
• Brandon Dental Care PA (Family Dental Spa of Brandon)
• Brandon Endodontics, PA (Advanced Endodontics of Tampa Bay)
• Brandon Eye Associates PA (Brandon Eye Associates)
• Brandon Facility Operations LLC (Raydiant Health Care of Brandon)
• Brandon Family Dental Care LLC
• Brandon Family Medical Care PA

• Dermatology Physician in Brandon, FL
• Providers in Brandon, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2008; 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.