MEDICARE: DR. PANAYIOTIS VASILOUDES MD, PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207NS0135X	Procedural Dermatology Physician	ME78436	FL
2	207ND0101X	MOHS-Micrographic Surgery Physician	ME78436	FL
3	207NP0225X	Pediatric Dermatology Physician	ME78436	FL
4	207N00000X	Dermatology Physician	ME78436	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134129505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PANAYIOTIS VASILOUDES MD, PHD

Provider Business Mailing Address
First Line	:	PO BOX 23329
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-3329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6331 MEMORIAL HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33615-4537
Country	:	US
Telephone Number	:	813-682-1031
Fax Number	:	813-682-1032

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	05/05/2026

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