Water's Edge Dermatology, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

800019024 Issued in FL

Legal business name

WATER'S EDGE DERMATOLOGY, LLC

Practice address

600 Village Square Xing
Suite 201
Palm Beach Gardens, FL 33410-4542

Phone

(561) 721-2400

Fax

(561) 721-1249

NPI assigned

May 8, 2006

Last updated

Jan 27, 2016By 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

Susan Davis, AUTHORIZED OFFICIAL

Title

Dir Billing Operations

Phone

(561) 693-0540

Specialties & licenses 1

Addresses

Other names 1

• Water's Edge Dermatology, Inc Former legal business name

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

Practitioners 61

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.

• Danica Alexander, D.O.

  • Dermatology Physician
  • Orlando, FL
  • NPI 1508088980
  NPD
• Sharon Gwyn Barrineau, ARNP

  • Nurse Practitioner
  • Okeechobee, FL
  • NPI 1407027873
  NPD
• Shireen Bower, MSN, FNP-BC, NP-C

  • Family Nurse Practitioner
  • Boca Raton, FL
  • NPI 1477097442
  NPD
• Kelli Danielle Bryant, M.D.

  • Dermatology Physician
  • Wellington, FL
  • NPI 1881127108
  NPD
• Ronald G. Bush, M.D.

  • Surgery Physician
  • Palm Beach Gardens, FL
  • NPI 1578565461
  NPD
• Christopher Robin Cromwell, MD

  • Plastic and Reconstructive Surgery Physician
  • Port Saint Lucie, FL
  • NPI 1629073382
  NPD
• Bobbi Jo Darr

  • Family Nurse Practitioner
  • Orange City, FL
  • NPI 1659756377
  NPD
• Laura Destefano, DO

  • Dermatology Physician
  • Cape Coral, FL
  • NPI 1003145087
  NPD
• Darron D Digiulio, D.O.

  • Dermatology Physician
  • Plantation, FL
  • NPI 1144281395
  NPD
• Stefan Marc Kristofer Doig, M.D.

  • Dermatology Physician
  • Avon Park, FL
  • NPI 1134462609
  NPD
• Geraldine Brandefine Emanuel, ARNP

  • Nurse Practitioner
  • Palm Beach Gardens, FL
  • NPI 1023065083
  NPD
• Julie Frederickson Forero, D.O.

  • Dermatology Physician
  • South Miami, FL
  • NPI 1356637300
  NPD

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

{
    "created_epoch": "1147046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453852800000",
    "number": "1871542787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104542",
            "telephone_number": "561-721-2400",
            "fax_number": "561-721-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 VILLAGE SQUARE XING",
            "address_2": "SUITE 201",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334104542",
            "telephone_number": "561-721-2400",
            "fax_number": "561-721-1249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER'S EDGE DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-08",
        "last_updated": "2016-01-27",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "DIR BILLING OPERATIONS",
        "authorized_official_telephone_number": "561-693-0540",
        "authorized_official_credential": "AUTHORIZED OFFICIAL"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "FL",
            "license": "800019024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Water's Edge Dermatology, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Carly Washor, LCSW, MCAP, ICADC
• Lyam Cristina Wasko, LMT
• Alex Wasserman, DC
• Karen Estelle Wasserman, LCSW
• Water's Edge Dermatology, LLC
• Jack Waterman, D.O.
• Waterway Wellness & Psychiatry, LLC
• Miriam R Watkins, DC
• Grace Watson, RN
• Joseph Gerald Watson, DMD

• Clinical Medical Laboratory in Palm Beach Gardens, FL
• Providers in Palm Beach Gardens, FL by specialty
• Clinical Medical Laboratory in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.