DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC (NPI# 1174078281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174078281 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC |
| Practice Address |
7250 Red Bug Lake Rd Ste 1020 Oviedo FL 32765 |
| Mailing Address |
7250 Red Bug Lake Rd Ste 1020 Oviedo FL 32765-9290 |
| Practice Telephone | 4077061770 |
| Mailing Telephone | 4077061770 |
| Mailing Fax Number | 4076503455 |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2018-06-03 |
| Authorized Official Name | VITALY BLATNOY (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 4077061770 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 001633600 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 422 S Alafaya Trl Ste 26, Orlando, FL 328288984 | 4075383855 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134617533 | Dermatology and Skin Cancer Surgery Center, LLC | Dermatology | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765-9290 | 2018-05-01 |
| Street Address |
7250 RED BUG LAKE RD STE 1020 |
| City | OVIEDO |
| State | FL |
| Zip Code | 32765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295386563 | Paula Cusi | Physician Assistant | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765-9290 | 2019-09-26 |
| 1912487786 | Janet Lorraine Gonzalez | Nurse Practitioner | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765-9290 | 2018-08-20 |
| 1134617533 | Dermatology and Skin Cancer Surgery Center, LLC | Dermatology | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765-9290 | 2018-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316576663 | Robby Hoffmann | Physical Therapist | 800 Red Bug Lake Road, Oviedo, FL 32765 | 2020-04-07 |
| 1366096836 | Brian Timothy Lowney | Pharmacist | 2871 Clayton Crossing Way #1001, Oviedo, FL 32765 | 2019-08-01 |
| 1083184634 | Ashley Grace Fuller | Speech-Language Pathologist | 251 Plaza Drive Suite C, Oviedo, FL 32765 | 2018-11-27 |
| 1164904678 | Katharine Albarella | Dietitian, Registered | 905 S. Lake Jessup Ave, Oviedo, FL 32765 | 2018-08-30 |
| 1871082396 | Catherine Victoria Wahl | Behavior Technician | 1350 San Remo Pt Apt 102, Oviedo, FL 32765 | 2018-05-10 |
| 1366943953 | Oviedo Smiles Dentistry, Pa | Dentist | 65 W. Mitchell Hammock Rd., Suite 1511, Oviedo, FL 32765 | 2018-02-28 |
| 1407385792 | Affordable Dentist | Dentist | 3228, W State Road 426, Suite 1000, Oviedo, FL 32765 | 2017-06-08 |
| 1104360221 | Mid Florida Hematology and Oncology Centers Pa | Internal Medicine | 658 Oviedo Medical Drive, Oviedo, FL 32765 | 2016-12-08 |
| 1780038463 | Matthew Christo | Counselor | 5076 Sugberry Trail, Oviedo, FL 32765 | 2016-04-19 |
| 1366801763 | All Dolled Up Unisex Beauty Salon | Specialist | 3228 W. State Road 426, Suite 1008, Oviedo, FL 32765 | 2016-02-15 |
| Find all providers in zip 32765 | ||||
| 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 |
|---|---|---|---|---|
| 1336259886 | Jere Mammino | Dermatology | 1410 W Broadway St Ste 102, Oviedo, FL 32765-6537 | 2006-08-30 |
| 1669462123 | Vitaly Blatnoy | Dermatology | 7250 Red Bug Lake Rd, Suite 1020, Oviedo, FL 32765-9290 | 2005-10-26 |
| 1134617533 | Dermatology and Skin Cancer Surgery Center, LLC | Dermatology | 7250 Red Bug Lake Rd Ste 1020, Oviedo, FL 32765-9290 | 2018-05-01 |
| 1588002059 | Rajiv Kiran Nathoo | Dermatology | 1410 W Broadway St Ste 205, Oviedo, FL 32765-6472 | 2013-06-06 |
| 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 | ||||
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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.