FLORIDA CENTER FOR DERMATOLOGY, P.A. (NPI# 1073870341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073870341 |
| Entity Type | Organization |
| Organization Name | FLORIDA CENTER FOR DERMATOLOGY, P.A. |
| Practice Address |
105 Southpark Blvd Suite A103 St Augustine FL 32086-5191 |
| Practice Telephone | 9043427765 |
| Practice Fax Number | 9043427770 |
| Mailing Telephone | 9043427765 |
| Mailing Fax Number | 9043427770 |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-04-11 |
| Authorized Official Name | DR. JONATHAN KANTOR (PRESIDENT) |
| Authorized Official Telephone | 9043427765 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | ME92201 | FL | Allopathic & Osteopathic Physicians |
| Street Address |
105 SOUTHPARK BLVD SUITE A103 |
| City | ST AUGUSTINE |
| State | FL |
| Zip Code | 32086-5191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710987805 | Brett Cutler | Podiatrist | 105 Southpark Blvd, Ste A103, St Augustine, FL 32086-4162 | 2005-07-29 |
| 1043618077 | Cynthia Washington | Nurse Practitioner | 105 Southpark Blvd, C-300, St Augustine, FL 32086-5191 | 2014-12-08 |
| 1215253893 | St. Augustine Foot & Ankle, Inc. | Non-Pharmacy Dispensing Site | 105 Southpark Blvd, Ste A103, St Augustine, FL 32086-5191 | 2010-04-08 |
| 1164676367 | Margaret E Martin | Nurse Practitioner | 105 Southpark Blvd, Suite C-300, St Augustine, FL 32086-5191 | 2008-11-14 |
| 1194927640 | Brett Cutler Dpm Pa | Podiatrist | 105 Southpark Blvd, Suite A103, St Augustine, FL 32086-4162 | 2007-06-05 |
| 1144383746 | Ouch, Pa | Specialist | 105 Southpark Blvd, Suite C 300, St Augustine, FL 32086-4162 | 2006-12-18 |
| 1467532697 | St Augustine Medical Equipment LLC | Durable Medical Equipment & Medical Supplies | 105 Southpark Blvd, Ste A101, St Augustine, FL 32086 | 2006-10-16 |
| 1164532552 | Alice G Beard | Physician Assistant | 105 Southpark Blvd, A103, St Augustine, FL 32086-5191 | 2006-08-30 |
| 1801828553 | Jyoti Patel | Anesthesiology | 105 Southpark Blvd, Ste C-300, St Augustine, FL 32086-4162 | 2006-07-06 |
| 1649209842 | Elena Stanescu | Anesthesiology | 105 Southpark Blvd, Suite C-300, St Augustine, FL 32086-4162 | 2006-07-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225670037 | Ramonica Flagler | Nurse Practitioner | 3574 Us-1 South, St. Augustine, FL 32086 | 2019-10-14 |
| 1518522648 | Marissa Marie Lynch | Physician Assistant | 100 Whetstone Pl Ste 102, St Augustine, FL 32086 | 2019-05-03 |
| 1346706991 | Castillo Transportation | Non-emergency Medical Transport (VAN) | 295 North Hidden Tree Dr, Saint Augustine, FL 32086 | 2019-02-19 |
| 1790255842 | Michelle Moore | In Home Supportive Care | 135 Jenkins St. Suite 105b #265, St.augustine, FL 32086 | 2018-12-03 |
| 1649740200 | Paul James Lietz IIi | Physical Therapist | One Orthopedic Place, Saint Augustine, FL 32086 | 2018-11-27 |
| 1548764707 | Oceanside Endodontics Od St. Augustine | Dentist | 2510 U.S. 1 South, Suite B, St. Augustine, FL 32086 | 2018-03-22 |
| 1023538329 | Joseph R Edwards | Physical Therapist | 968 Espinado Avenue, St Augustine, FL 32086 | 2017-06-27 |
| 1235662032 | Jennifer L Csenge | Dentist | 4327 Us Highway 1 S, St Augustine, FL 32086 | 2017-04-07 |
| 1336683663 | Lisa Brice | Social Worker | 248 Southpark Circle East, Saint Augustine, FL 32086 | 2016-12-06 |
| 1558813303 | Bio-medical Applications of Florida, Inc. | Clinic/Center | 65 Whitehall Drive, Saint Augustine, FL 32086 | 2016-10-27 |
| Find all providers in zip 32086 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952800112 | Premier Dermatology of Florida LLC | Dermatology | 1201 Arapaho Ave Ste A, St Augustine, FL 32084-4204 | 2018-02-02 |
| 1457501934 | David J Gross Md Pa | Dermatology | 1100-3 S Ponce De Leon Blvd, Suite 3b, St Augustine, FL 32084-6013 | 2008-09-22 |
| 1346225828 | David J Gross | Dermatology | 1100-3 S Ponce De Leon, St Augustine, FL 32084 | 2005-12-07 |
| 1437568482 | Bruce H Paley Pa | Dermatology | 1851 Old Moultrie Rd, Suite B, St Augustine, FL 32084-4168 | 2014-08-04 |
| 1215265814 | Christina Brennan | Dermatology | 1750 Tree Blvd, Suite 1, St Augustine, FL 32084-5715 | 2009-11-20 |
| 1619993375 | Bruce Henry Paley | Dermatology | 1851 Old Moultrie Rd, Suite B, St Augustine, FL 32084-4168 | 2006-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962002154 | Precision Skin LLC | Dermatology | 3501 S University Dr Ste 5, Davie, FL 33328-2001 | 2020-10-28 |
| 1487252417 | Janice Reaume | Dermatology | 3335 Imperial Manor Way, Mulberry, FL 33860-5519 | 2020-10-12 |
| 1922617729 | Synergymd, LLC | Dermatology | 1208 E Kennedy Blvd Ste 221, Tampa, FL 33602-3509 | 2020-07-28 |
| 1518585447 | Alexander F Wong | Dermatology | 1300 Goodlette-frank Rd N, Naples, FL 34102-5243 | 2020-07-07 |
| 1508495003 | Elite Dermatology | Dermatology | 401 Coral Way Ste 207, Coral Gables, FL 33134-4924 | 2020-04-06 |
| 1124668371 | Meaghan Margaret Birakis | Dermatology | 3319 Fl-7 #202, Wellington, FL 33449 | 2020-01-15 |
| 1396380044 | Suzanne Marie Smith | Dermatology | 21097 Ne 27th Ct Ste 500, Miami, FL 33180-1235 | 2019-11-15 |
| 1376188383 | Enchantress Dermatology, Inc. | Dermatology | 241 Nw 119 Ave, Miami, FL 33182-1329 | 2019-11-13 |
| 1699319988 | Revivify Dermatology, LLC | Dermatology | 21301 Powerline Rd # 108, Boca Raton, FL 33433-2388 | 2019-10-30 |
| 1841833928 | Carly Marie Maher | Dermatology | 90 Cypress Way E Ste 50, Naples, FL 34110-9275 | 2019-10-22 |
| Find all providers with the same taxonomy | ||||
| City | ST AUGUSTINE |
| Zip Code | 32086 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.