Dermatology and Skin Cancer Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

DERMATOLOGY AND SKIN CANCER CENTER

Practice address

7450 Dr Phillips Blvd
Suite 200
Orlando, FL 32819-5119

Phone

(407) 704-7546

Fax

(407) 374-2992

NPI assigned

Aug 23, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jeannette Louise Hudgens, MDNPI 1861618035

Title

Owner/Doctor

Phone

(407) 704-7546

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeannette Louise Hudgens, MD

  • Dermatology Physician
  • Windermere, FL
  • NPI 1861618035
  Medicare reassignment Care Compare group Authorized official
• Jennifer Lynn Brinckerhoff, PA-C

  • Medical Physician Assistant
  • Orlando, FL
  • NPI 1902209844
  Medicare reassignment Care Compare group
• Madison Lynne Vasmout, PA-C

  • Dermatology Physician
  • Windermere, FL
  • NPI 1093355653
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1891001293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7450 DR PHILLIPS BLVD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195119",
            "telephone_number": "407-704-7546",
            "fax_number": "407-374-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7450 DR PHILLIPS BLVD",
            "address_2": "SUITE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328195119",
            "telephone_number": "407-704-7546",
            "fax_number": "407-374-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN CANCER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-23",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "HUDGENS",
        "authorized_official_first_name": "JEANNETTE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "407-704-7546",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herman Brace Deresma, APRN
• Krystal Derico
• Triston Derieux
• Yonile Derivois, HOME HEALTH AIDE
• Dermalier Clinic LLC
• Jamie Deron
• Joanna Derosa
• Dawn Michelle Derrick, ARNP
• Loreen Derry
• Malia Dersch, APRN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.