MEDICARE: SKIN WELLNESS PHYSICIANS, LLC

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	207N00000X	Dermatology Physician	ME107188	FL

General Provider Information

NPI Number	:	1275952244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKIN WELLNESS PHYSICIANS, LLC

Provider Business Mailing Address
First Line	:	8625 COLLIER BLVD
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3601
Country	:	US
Telephone Number	:	239-732-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	8625 COLLIER BLVD UNIT 101
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34114-3636
Country	:	US
Telephone Number	:	239-732-0044
Fax Number	:	239-732-0094

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DANIEL I WASSERMAN
Credential	:	MD
Telephone Number	:	239-732-0044

Provider Enumeration Date	:	04/07/2014
Last Update Date	:	12/23/2025

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