Unknown Individual – Dermatology Physician, NPI 1477574044
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Loading map...
Provider Addresses for Unknown Individual
151 Southpoint, 151, Southhall Lane, Maitland, Orange County, Florida, 32810, United States
STE 300
MAITLAND, FL 327517176
Phone: (407) 875-2080
Fax: (407) 650-3455
Type: Mailing
3, Pine Cone Drive, Palm Coast, Flagler County, Florida, 32137, United States
UNIT 102
PALM COAST, FL 321378685
Phone: (386) 864-6005
Fax: (386) 864-6110
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 21 Open Payments records for all available years, with a total value of $410.
Total Amount is formed as General ($410) + Research ($0) + Ownership ($0) = $410.
Last reported payment date: 2024-09-19 • Largest payer in this snapshot: ABBVIE INC. ($309).
Total Amount
$410
General + Research + Ownership
Payments
21
Total payment records
General Amount
$410
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-09-19
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32751)
Loading plans...
Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | FL | 17003 | Destruction of 2-14 skin growths | 280 | 49 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NV | |
| D E R M A T O L O G Y | FL | |
| - | FL | |
| Nurse Practitioner | FL | |
| - | FL | |
| Dermatology, Micrographic Dermatologic Surgery (Mds) | FL | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | FL | |
| - | FL | |
| D E R M A T O L O G Y | MI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.