Legends Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

LEGENDS DERMATOLOGY, LLC

Practice address

1497 Legends Boulevard
Davenport, FL 33896

Phone

(863) 738-5487

NPI assigned

Dec 4, 2014

Last updated

Sep 26, 2019By 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

Iulia Funieru, MDNPI 1760435507

Title

Sole Owner

Phone

(863) 738-5487

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 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.

• Iulia Funieru, MD

  • Dermatology Physician
  • Champions Gate, FL
  • NPI 1760435507

  Specialist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1417651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569456000000",
    "number": "1780081869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 LEGENDS BOULEVARD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "863-738-5487",
            "fax_number": "863-619-7094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 LEGENDS BOULEVARD",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "33896",
            "telephone_number": "863-738-5487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDS DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-04",
        "last_updated": "2019-09-26",
        "status": "A",
        "authorized_official_last_name": "FUNIERU",
        "authorized_official_first_name": "IULIA",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "863-738-5487",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria C Leal Colina
• Danica Joyce Leblanc, LPC
• Andres Eduardo Lebrun Caceres
• Jun-Ho Lee
• Lillian Leeds
• Steven Leger, ARNP
• Michelle Legros
• Yenny Sulay Leon, LMHC, 20658
• Karen Leonard
• Carolina Gemma Leuthner, M.A. CCC-SLP

• Dermatology Physician in Davenport, FL
• Providers in Davenport, 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 26, 2019; 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.