Florida Institute of Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FLORIDA INSTITUTE OF DERMATOLOGY LLC

Practice address

1503 Buenos Aires Blvd Ste 130
The Villages, FL 32159-6826

Phone

(407) 395-3770

Fax

(407) 395-3779

NPI assigned

Jun 2, 2021

Last updated

Jun 2, 2021By 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

Michael Waudo Wangia, MDNPI 1548495955

Title

Physician/Owner

Phone

(352) 594-1942

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Florida Institute of Dermatology LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Florida Institute of Dermatology LLC

  • Dermatology Physician
  • Apopka, FL
  • NPI 1912573684
  NPD tax ID

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.

• Michael Waudo Wangia, MD

  • Dermatology Physician
  • Winter Garden, FL
  • NPI 1548495955
  NPD (past) Authorized official

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1952977621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 BUENOS AIRES BLVD STE 130",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596826",
            "telephone_number": "407-395-3770",
            "fax_number": "407-395-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 BUENOS AIRES BLVD STE 130",
            "city": "THE VILLAGES",
            "state": "FL",
            "postal_code": "321596826",
            "telephone_number": "407-395-3770",
            "fax_number": "407-395-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA INSTITUTE OF DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "WANGIA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WAUDO",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "352-594-1942",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME112379",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Florida Cancer Specialists & Research Institute, LLC
• Florida Cancer Specialists P L (Florida Cancer Specialists)
• Florida Cardiovascular Specialists, PA
• Florida Dermatologic Surgery & Aesthetics Institute PA
• Florida Heart & Vascular Multi Specialty Group, PA
• Florida Orthocare, LLC
• Florida Pathology PA
• Susan Marie Forbes, PSY.D.
• Laverne Ford
• Anita Catherine Forsythe, NP

• Dermatology Physician in The Villages, FL
• Providers in The Villages, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.