Long Medical PLLC
Dermatology in The Villages, FL. Organization (NPI-2).
NPI number1942006069
StatusActive
Last updated in NPPESJul 16, 2025
Details
- NPI
- 1942006069
- Entity type
- Organization (NPI-2)
- Legal business name
- Long Medical PLLC
- Organization subpart
- No
- Enumeration date
- Feb 20, 2025
- Certification date
- Jul 16, 2025
- Last updated
- Jul 16, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | – | – | |
| 207NS0135X | Dermatology, Procedural Dermatology | – | – |
Other names
- Spotdoc Brownwood (Doing Business As)
Practice location
3614 Kiessel RdThe Villages, FL 32163-2910
Phone 352-914-3451 · Fax 352-415-3952
Mailing address
3614 Kiessel RdThe Villages, FL 32163-2910
Phone 352-914-3451 · Fax 352-415-3952
Authorized official
Tyler Jon Long
Owner/Physician
3529143451
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