Coast Dermatology and Skin Cancer Center PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

OS0006785 Issued in FL

Legal business name

COAST DERMATOLOGY AND SKIN CANCER CENTER PA

Practice address

21550 Angela LN
Venice, FL 34293-2017

Phone

(941) 493-7400

Fax

(941) 493-1940

NPI assigned

Mar 20, 2007

Last updated

May 22, 2009By 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

John Gregory Neily, D.O.NPI 1760553630

Title

Physcian

Phone

(941) 493-7400

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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.

• John Gregory Neily, DO

  • Specialist
  • Venice, FL
  • NPI 1760553630
  Authorized official Same address or phone

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242950400000",
    "number": "1770608937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21550 ANGELA LN",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342932017",
            "telephone_number": "941-493-7400",
            "fax_number": "941-493-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21550 ANGELA LN",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342932017",
            "telephone_number": "941-493-7400",
            "fax_number": "941-493-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST DERMATOLOGY AND SKIN CANCER CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-05-22",
        "status": "A",
        "authorized_official_last_name": "NEILY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PHYSCIAN",
        "authorized_official_telephone_number": "941-493-7400",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "OS0006785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD GROUP NUMBER",
            "identifier": "99100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diane K Clukey Chenard, LCSW
• Alice Clukey
• Camryn Clune
• Susan Lorene Clyne, DO
• Courtney Coakes, PA-C
• Coastal Care Nursing Associates, Inc
• Coastal Family Medicine PL
• Coastal in Home Medical, LLC
• Coastal Insurance
• Coastal Peaks Psychiatry PLLC

• Specialist in Venice, FL
• Providers in Venice, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.