Active NPI
Dermacare Senior Solutions LLC
- Nurse Practitioner
- Lake Mary, FL
National Provider Identifier
1972391357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- Legal business name
- DERMACARE SENIOR SOLUTIONS LLC
- Practice address
- 731 Stirling Center PL Unit 1931
Lake Mary, FL 32746-5209 - Phone
- (386) 523-8345
- NPI assigned
- Apr 28, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Alexander Terentev
- Title
- Chief Executive Officer
- Phone
- (386) 523-8345
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | |||
| Nurse Practitioner | 363L00000X | Primary |
Addresses
Primary practice location
731 Stirling Center PL Unit 1931
Lake Mary, FL 32746-5209
Mailing address
782 Lake Como Dr
Lake Mary, FL 32746-4811
Phone (386) 523-8345
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250825002397 | FL | Part B Supplier - Clinic/Group Practice | 7113427006 |
Receives reassigned benefits from 10 practitioners Practice locations: Lake Mary, FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Port St Lucie, FL
- NPI 1235989401
FL, Nurse Practitioner
-
- Family Medicine Physician
- Orlando, FL
- NPI 1821168972
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1745798400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1745798400000",
"number": "1972391357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "782 LAKE COMO DR",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327464811",
"telephone_number": "386-523-8345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "731 STIRLING CENTER PL UNIT 1931",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465209",
"telephone_number": "386-523-8345"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMACARE SENIOR SOLUTIONS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-04-28",
"last_updated": "2025-04-28",
"certification_date": "2025-04-27",
"status": "A",
"authorized_official_last_name": "TERENTEV",
"authorized_official_first_name": "ALEXANDER",
"authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "386-523-8345",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; 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.