Provider Demographics
NPI:1043453970
Name:WASSERMAN, JUSTIN ROSS (MD)
Entity type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:ROSS
Last Name:WASSERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:409 SERANO WAY UNIT 101
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-5241
Mailing Address - Country:US
Mailing Address - Phone:941-484-8222
Mailing Address - Fax:941-486-3016
Practice Address - Street 1:409 SERANO WAY UNIT 101
Practice Address - Street 2:
Practice Address - City:NOKOMIS
Practice Address - State:FL
Practice Address - Zip Code:34275-5241
Practice Address - Country:US
Practice Address - Phone:941-484-8222
Practice Address - Fax:941-486-3016
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-08
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME106806207ND0900X, 207N00000X, 207ND0900X
IL036122668207ND0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology