NPIMap

Organization Active NPI

Mid-Florida Dermatology Associates

Doing business as Hunter Phillips Dermatology

  • Specialist
  • Orlando, FL
National Provider Identifier
1952716516
Registry record updated Jun 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0050355 Issued in FL
Legal business name
MID-FLORIDA DERMATOLOGY ASSOCIATES
Doing business as
Hunter Phillips Dermatology
Practice address
7652 Ashley Park CT
Suite 305
Orlando, FL 32835-6199
Phone
(407) 299-7333
Fax
(407) 293-2049
NPI assigned
Jun 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2014

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

Authorized official

Name
Michael M Gutierrez, M.D.NPI 1881630119
Title
Aole Owner
Phone
40729997333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X ME0050355 FL Primary

Addresses

Primary practice location

7652 Ashley Park CT
Suite 305
Orlando, FL 32835-6199

Mailing address

7652 Ashley Park CT
Suite 305
Orlando, FL 32835-6199
Phone (407) 299-7333

Other names 1

  • HUNTER PHILLIPS DERMATOLOGY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141008000954 MS Part B Supplier - Clinic/Group Practice 1254233786 Receives reassigned benefits from 3 practitioners
Practice locations: Biloxi, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1403481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403481600000",
    "number": "1952716516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7652 ASHLEY PARK CT",
            "address_2": "SUITE 305",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356199",
            "telephone_number": "407-299-7333",
            "fax_number": "407-293-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7652 ASHLEY PARK CT",
            "address_2": "SUITE 305",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328356199",
            "telephone_number": "407-299-7333",
            "fax_number": "407-293-2049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-FLORIDA DERMATOLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-23",
        "last_updated": "2014-06-23",
        "status": "A",
        "authorized_official_last_name": "GUTIERREZ",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "AOLE OWNER",
        "authorized_official_telephone_number": "40729997333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0050355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HUNTER PHILLIPS DERMATOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2014; 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.