LAKELAND DERMATOLOGY
NPI 1255403762
Specialist in Lakeland, FL
NPI Status: Active since November 14, 2006
Contact Information
202 LAKE MIRIAM DR STE S1
LAKELAND, FL
ZIP 33813
Phone: (863) 647-2333
Fax: (863) 393-1995
- Organization
- Specialist
- CLIA Number: 10D2314498
- CLIA Cert. Type: Other - FREE STANDING EMERGENCY D
- CLIA Exp. Date: 11-20-2026
About LAKELAND DERMATOLOGY
This page provides the complete NPI Profile along with additional information for Lakeland Dermatology, a provider established in Lakeland, Florida operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1255403762 assigned on November 2006. The practitioner's primary taxonomy code is 174400000X. The provider is registered as an organization and their NPI record was last updated 15 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is David W Murray Md (Md)
- NPI
- 1255403762
- Provider Name
- LAKELAND DERMATOLOGY
- Entity Type
- Organization
- Location Address
- 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813
- Location Phone
- (863) 647-2333
- Location Fax
- (863) 393-1995
- Mailing Address
- 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813
- Mailing Phone
- (863) 647-2333
- Mailing Fax
- (863) 393-1995
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 11-14-2006
- Last Update Date
- 11-04-2010
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Specialist
- Taxonomy Code
- 174400000X
- Type
- Other Service Providers
- Taxonomy Description
- An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D2314498
- Facility Type
- Other - FREE STANDING EMERGENCY D
- Certificate Effective Date
- November 21, 2024
- Certificate Expiration Date
- November 20, 2026
- Laboratory Director
- BRIAN J. YODER
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Lakeland Dermatology on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 5 | 5 | 4 | 0 | 3 | 7 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 10 | 5 | 8 | 0 | 6 | 7 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 1 + 0 + 5 + 8 + 0 + 6 + 7 + 1 + 2 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1255403762 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 4 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669453221 | MR. KIM G COLE PA Individual | Physician Assistant (Medical) | 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813 (863) 647-2333 |
| 1184961419 | BOBBIE FERRELL ARNP Individual | Nurse Practitioner | 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813 (863) 647-2333 |
| 1457842197 | CAITLIN R. FREDERICKA Individual | Nurse Practitioner | 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813 (863) 647-2333 |
| 1780339325 | SAMANTHA LEE RIOS APRN Individual | Nurse Practitioner | 202 LAKE MIRIAM DR STE S1 LAKELAND, FL 33813 (866) 400-3376 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1255403762, enumerated in the NPI registry as an "organization" on November 14, 2006
The provider is located at 202 Lake Miriam Dr Ste S1 Lakeland, Fl 33813 and the phone number is (863) 647-2333
This medical organization specializes in Specialist with taxonomy code 174400000X
The provider's CLIA number is 10D2314498 for a "other - free standing emergency d" facility with a CLIA Certificate of Accreditation. This is a CLIA certificate is issued on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing..
This NPI record was last updated on November 14, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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