Active NPI 1386695054 Individual Practitioner Male Practitioner

Dr. Michael Jay Bernhardt , MD

Dermatology • Jacksonville, FL

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Bernhardt, MD is a certified Dermatology practicing in Jacksonville, FL. With approximately 46 years of clinical experience since graduating from Emory University School Of Medicine in 1980, Dr. Bernhardt delivers high-quality medical care to the local community at 7711 BAYMEADOWS RD E STE 6.

Dr. Bernhardt is affiliated with Suncoast Skin Solutions and accepts Medicare assignment.

Frequently performed procedures and clinical services include aminolevulinic acid hcl for topical administration, 10% gel, 10 mg, destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

7711 Baymeadows Rd E Ste 6

Jacksonville, FL 322569110

Telephone 8133211786

Fax 8133211787

Associated Practice Facility / Clinic

🏢 Dermatology Specialists Of North Florida, P.a. Facility NPI 1285661710

Medicare Profile & Education

Medical School

Emory University School Of Medicine

Graduation Year

1980

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Jacksonville, FL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

46 Yrs +24.6 yrs vs City Avg

City Avg: 21.4 Yrs

State Avg: 23.7 Yrs

Regional Practice Density

59 Specialists

Practicing in Jacksonville, FL (1273 Statewide)

Telehealth Adoption Rate

8.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

61.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Bernhardt (46 Years) 46 Yrs

Jacksonville Specialty Average (21.4 Years) 21.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J7345 Aminolevulinic acid hcl for topical administration, 10% gel, 10 mg	5,201	23	$2.50	$1.68
17003 Destruction of precancer skin growth, 2-14 growths	1,007	164	$44.00	$6.21
99213 Established patient office or other outpatient visit, typically 15 minutes	523	373	$156.00	$87.90
17000 Destruction of skin growth	299	220	$190.00	$47.27
11102 Tangential biopsy of single skin lesion	234	190	$172.00	$83.81
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	194	114	$241.00	$124.13
96900 Application of ultraviolet light to skin	186	13	$52.00	$23.22
17110 Destruction of up to 14 skin growths	154	125	$200.00	$103.55
11103 Biopsy of related skin growth, each additional growth	117	66	$93.00	$47.83
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	92	92	$285.00	$108.36
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	69	47	$110.00	$54.50
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	56	18	$51.00	$13.73
11104 Punch biopsy, first skin growth	47	44	$217.00	$112.62
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	46	34	$540.00	$115.12
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	38	34	$603.00	$279.16
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	37	12	$5.00	$1.00
11105 Punch biopsy, each additional skin growth	26	21	$107.00	$54.57
69100 Biopsy of ear	22	22	$253.00	$54.06
Q0112 All potassium hydroxide (koh) preparations	21	18	$10.00	$5.44
17004 Destruction of precancer skin growth, 15 or more growths	21	19	$606.00	$159.98
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	18	14	$370.00	$119.06
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	18	13	$934.00	$396.02
96574 Application of light with debridement to destroy precancer skin growth	17	15	$442.12	$259.32
99202 New patient office or other outpatient visit, typically 20 minutes	16	16	$190.00	$67.32
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	15	13	$601.00	$134.28
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$402.00	$163.80
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	13	12	$205.00	$125.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	882	149	$44.00	$6.26
99213 Established patient office or other outpatient visit, typically 15 minutes	553	360	$156.00	$88.26
17000 Destruction of skin growth	269	201	$190.00	$50.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	177	98	$241.00	$123.52
11102 Tangential biopsy of single skin lesion	174	131	$172.00	$86.05
17110 Destruction of up to 14 skin growths	154	130	$200.00	$106.01
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	79	15	$51.00	$13.68
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	67	67	$285.00	$109.52
11103 Biopsy of related skin growth, each additional growth	64	38	$93.00	$48.78
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	57	43	$110.00	$55.22
17004 Destruction of precancer skin growth, 15 or more growths	29	23	$606.00	$164.72
11104 Punch biopsy, first skin growth	21	20	$217.00	$113.31
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	20	15	$486.00	$384.74
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	19	17	$603.00	$275.35
96567 Application of light and light-sensitive drugs to aid destruction of premalignant skin growths, per session	17	15	$205.00	$132.47
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	16	13	$934.00	$416.19
Q0112 All potassium hydroxide (koh) preparations	16	13	$10.00	$5.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$402.00	$164.01
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	14	12	$601.00	$136.98

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	775	140	$42.99	$6.47
99213 Established patient office or other outpatient visit, typically 15 minutes	402	283	$154.38	$89.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	339	221	$240.67	$124.69
17000 Destruction of skin growth	242	188	$186.95	$51.53
11102 Tangential biopsy of single skin lesion	156	132	$171.10	$90.16
17110 Destruction of up to 14 skin growths	93	80	$200.00	$108.87
11103 Biopsy of related skin growth, each additional growth	85	52	$93.00	$50.53
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	68	16	$5.00	$0.97
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	57	57	$397.91	$168.07
11104 Punch biopsy, first skin growth	49	46	$217.00	$121.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	41	41	$285.00	$111.93
17004 Destruction of precancer skin growth, 15 or more growths	24	22	$606.00	$165.92
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	20	15	$540.00	$121.77
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	20	15	$51.00	$12.25
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	18	15	$486.00	$390.20
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	17	$603.00	$283.32
96573 Application of light by qualified health care professional to destroy precancer skin growth	16	15	$325.00	$227.62
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	15	11	$344.48	$159.96
11105 Punch biopsy, each additional skin growth	15	13	$107.00	$56.16
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	15	13	$106.44	$55.86
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	13	13	$856.00	$398.73
11402 Removal of noncancer skin growth of body, arms, or legs, 1.1-2.0 cm	12	12	$479.00	$86.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,942	377	$16.19	$6.36
99213 Established patient office or other outpatient visit, typically 15 minutes	1,060	806	$175.34	$91.85
17000 Destruction of skin growth	572	486	$137.60	$53.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	258	218	$243.63	$130.31
11102 Tangential biopsy of single skin lesion	257	234	$197.12	$96.58
17110 Destruction of up to 14 skin growths	250	220	$221.27	$110.21
17004 Destruction of precancer skin growth, 15 or more growths	113	99	$360.15	$165.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	104	104	$231.77	$113.49
11103 Biopsy of related skin growth, each additional growth	98	64	$98.77	$52.73
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	34	32	$505.56	$157.70
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	27	27	$377.36	$170.31
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	26	24	$355.77	$172.06
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	22	20	$867.95	$437.84
11104 Punch biopsy, first skin growth	21	21	$225.85	$129.51
17282 Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	21	20	$413.77	$202.79
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	19	17	$568.39	$142.30
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	18	17	$814.64	$408.59
13132 Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm	15	15	$976.38	$484.02
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	14	14	$608.95	$309.29
11642 Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm	12	12	$572.84	$136.87
17111 Destruction of skin growth, 15 or more growths	12	11	$257.33	$126.83
69100 Biopsy of ear	11	11	$202.20	$85.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	2,311	468	$11.52	$5.95
99213 Established patient office or other outpatient visit, typically 15 minutes	925	774	$150.01	$75.42
17000 Destruction of skin growth	708	621	$132.11	$52.63
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	470	442	$219.06	$108.91
11102 Tangential biopsy of single skin lesion	344	326	$208.22	$93.64
17110 Destruction of up to 14 skin growths	324	302	$224.28	$110.93
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	145	145	$218.18	$108.25
17004 Destruction of precancer skin growth, 15 or more growths	116	109	$312.33	$159.24
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	67	63	$90.20	$44.16
11103 Biopsy of related skin growth, each additional growth	62	46	$111.78	$53.41
99202 New patient office or other outpatient visit, typically 20 minutes	51	51	$152.86	$74.66
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	32	18	$11.96	$1.47
J7308 Aminolevulinic acid hcl for topical administration, 20%, single unit dosage form (354 mg)	28	24	$430.00	$386.74
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	26	26	$355.12	$155.37
96574 Application of light with debridement to destroy precancer skin growth	26	23	$498.00	$263.81
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	23	22	$866.16	$421.74
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	21	19	$500.21	$125.85
11603 Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm	18	18	$570.37	$143.08
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	17	16	$610.38	$304.02
11104 Punch biopsy, first skin growth	15	15	$266.77	$125.35
11900 Injection into skin growth, 1-7 growths	14	13	$114.66	$42.96
69100 Biopsy of ear	13	13	$202.19	$94.65
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	12	11	$294.58	$120.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,635	332	$20.33	$5.62
99213 Established patient office or other outpatient visit, typically 15 minutes	905	705	$138.08	$73.67
11102 Tangential biopsy of single skin lesion	506	476	$254.34	$89.56
17000 Destruction of skin growth	504	443	$141.02	$48.97
17110 Destruction of up to 14 skin growths	336	300	$214.84	$107.78
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	321	321	$215.97	$108.05
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	285	280	$206.49	$107.87
11103 Biopsy of related skin growth, each additional growth	179	134	$137.60	$52.71
99202 New patient office or other outpatient visit, typically 20 minutes	100	100	$147.67	$75.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	78	74	$89.46	$44.55
17004 Destruction of precancer skin growth, 15 or more growths	61	57	$379.61	$151.98
69100 Biopsy of ear	38	36	$195.95	$81.40
11300 Shaving of 0.5 centimeters or less skin growth of the trunk, arms, or legs	26	21	$194.65	$65.33
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	23	13	$11.43	$1.59
11104 Punch biopsy, first skin growth	23	23	$331.09	$120.32
87101 Fungal culture (mold or yeast) of skin, hair, or nail	20	17	$37.00	$8.39
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	15	$355.76	$155.40
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	15	15	$774.40	$402.08
11900 Injection into skin growth, 1-7 growths	15	13	$113.13	$45.18
11401 Removal of noncancer skin growth of body, arms, or legs, 0.6-1.0 cm	13	13	$293.31	$145.39
11602 Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm	13	13	$478.92	$134.14

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	903	150	$34.51	$5.26
99213 Established patient office or other outpatient visit, typically 15 minutes	410	282	$134.52	$72.04
17000 Destruction of skin growth	250	196	$151.60	$51.97
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	235	235	$225.25	$106.73
11100 Biopsy of single growth of skin and/or tissue	184	165	$202.25	$96.69
17110 Destruction of up to 14 skin growths	160	139	$204.38	$109.86
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	117	102	$198.22	$106.26
99202 New patient office or other outpatient visit, typically 20 minutes	76	76	$148.79	$74.40
11101 Biopsy of each additional growth of skin and/or tissue	54	46	$97.37	$32.31
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	27	26	$94.11	$43.24
17004 Destruction of precancer skin growth, 15 or more growths	26	22	$451.38	$143.84
13121 Repair of wound (2.6 to 7.5 centimeters) of scalp, arms, and/or legs	14	12	$832.43	$425.49
87220 Tissue fungi or parasites	12	12	$22.00	$5.16

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	1,931	319	$14.11	$5.59
99213 Established patient office or other outpatient visit, typically 15 minutes	1,189	840	$136.51	$71.66
17000 Destruction of skin growth	517	411	$130.61	$53.14
11100 Biopsy of single growth of skin and/or tissue	381	335	$192.52	$95.64
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	375	306	$200.10	$105.30
17110 Destruction of up to 14 skin growths	293	249	$205.91	$107.23
11101 Biopsy of each additional growth of skin and/or tissue	120	98	$66.01	$32.86
99202 New patient office or other outpatient visit, typically 20 minutes	99	99	$136.46	$73.53
17004 Destruction of precancer skin growth, 15 or more growths	81	61	$284.63	$148.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	59	59	$205.66	$106.22
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	58	56	$85.09	$42.91
Q0112 All potassium hydroxide (koh) preparations	25	23	$22.64	$5.74
69100 Biopsy of ear	25	23	$191.80	$71.50
11200 Removal of skin tag, 1-15 skin tags	20	18	$166.00	$76.76
13101 Complicated repair of wound of trunk, 2.6-7.5 cm	11	11	$631.82	$392.21

Medical Specialties & State Licenses

CMS Verified: 2024-10-25

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License FL ME42082

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Hospital & Practice Group Affiliations

Suncoast Skin Solutions

7711 Baymeadows Rd E, Jacksonville, FL 322569110

Phone: 8133211786

Secondary Practice Locations

1626 Riggins Rd

Tallahassee, FL 323085316

Phone: 8508774134

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Megan Mcgill , PA-C

Physician Assistant

NPI 1013678887

Physician Assistant (Certified)

Brandi Broughton , PHYSICIAN ASSISTANT

Physician Assistant

NPI 1043406481

PHYSICIANASSISTANT

Dr. George Vonhilsheimer , MD

Dermatology

NPI 1063519254

Doctor of Medicine (M.D.)

Noreen Godfrey , PA-C

Physician Assistant

NPI 1063536670

Physician Assistant (Certified)

Jill Stchur , PA

Physician Assistant

NPI 1063958304

Physician Assistant

Chris Narsesian , NP

Nurse Practitioner - Family

NPI 1073159513

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

20 Historical Events

📍

Updated Practice Location October 25, 2024

Registered at 7711 BAYMEADOWS RD E STE 6, JACKSONVILLE, FL 322569110 (Tel: 8133211786)

📍

Updated Business Mailing Address October 25, 2024

Registered at 18228 N US HIGHWAY 41, LUTZ, FL 335494400 (Tel: 8133211786)

📍

Updated Practice Location June 22, 2021

Registered at 1626 RIGGINS RD, TALLAHASSEE, FL 323085316 (Tel: 8508774134)

📍

Updated Business Mailing Address June 22, 2021

Registered at PO BOX 13859, TALLAHASSEE, FL 323173859 (Tel: 8508774134)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 08, 2020

Dermatology (License #ME42082 in FL)

📍

Updated Practice Location April 14, 2020

Registered at 1849 S OSPREY AVE, SARASOTA, FL 342393614 (Tel: 9419574767)

📍

Updated Business Mailing Address April 14, 2020

Registered at 4919 MEMORIAL HWY, STE 150, TAMPA, FL 336347516 (Tel: 8133331512)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) April 14, 2020

Dermatology (License #57796 in AZ)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 12, 2020

Dermatology (License #ME42082 in FL)

📍

Updated Practice Location July 09, 2019

Registered at 14275 N 87TH ST STE 110, SCOTTSDALE, AZ 85260 (Tel: 4809058485)

📍

Updated Business Mailing Address July 09, 2019

Registered at 14275 N 87TH ST STE 110, SCOTTSDALE, AZ 852603696 (Tel: 4809058485)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2019

Dermatology (License #57796 in AZ)

📍

Updated Business Mailing Address March 17, 2018

Registered at PO BOX 13834, TALLAHASSEE, FL 323173834 (Tel: 8502056232)

📍

Updated Business Mailing Address March 12, 2018

Registered at PO BOX 13834, TALLAHASSEE, FL 323173834 (Tel: 8502056232)

✅

NPI Profile Active January 26, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location January 26, 2016

Registered at 1514 NIRA ST, JACKSONVILLE, FL 322079702 (Tel: 9043874991)

📍

Updated Business Mailing Address January 26, 2016

Registered at 1514 NIRA ST, JACKSONVILLE, FL 322079702 (Tel: 9043874991)

👤

Provider Name / Credentials Updated January 26, 2016

Recorded as MICHAEL BERNHARDT, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) January 26, 2016

Dermatology (License #ME0042082 in FL)

🟢

Initial NPI Registration & Enumeration May 15, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1386695054

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: May 15, 2006

Last Update: October 25, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

18228 N Us Highway 41

Lutz, FL 335494400

Phone: 8133211786

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.