SCA DERMATOLOGY, LLC (NPI# 1518232065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518232065 |
| Entity Type | Organization |
| Organization Name | SCA DERMATOLOGY, LLC |
| Practice Address |
915 W Monroe St S. 101 Jacksonville FL 32204-1177 |
| Mailing Address |
1111 Park Centre Blvd S. 300 Miami Gardens FL 33169-5365 |
| Practice Telephone | 9049034345 |
| Mailing Telephone | 3056235595 |
| Enumeration Date | 2012-03-16 |
| Last Update Date | 2017-03-14 |
| Authorized Official Name | RICHARD S, GREENE (MD / PRESIDENT) |
| Authorized Official Telephone | 9544736750 |
| Is Organization Subpart | Y |
| Parent Organization Name | SKIN AND CANCER ASSOCIATES, LLP |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
915 W MONROE ST S. 101 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32204-1177 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447252523 | David R Sutton Jr. | Specialist | 915 W Monroe St, Ste 200, Jacksonville, FL 32204-1177 | 2005-06-02 |
| 1558870345 | Habibu Barrie | Nurse Practitioner | 915 W Monroe St, Jacksonville, FL 32204-1177 | 2017-09-25 |
| 1215475157 | Christine Lee | Physician Assistant | 915 W Monroe St, Suite 200, Jacksonville, FL 32204-1177 | 2017-02-10 |
| 1962954990 | Diana Ugljesic | Nurse Practitioner | 915 W Monroe St, Suite 200, Jacksonville, FL 32204-1177 | 2016-10-25 |
| 1205381571 | Kathleen Frank Fort | Nurse Practitioner | 915 W Monroe St, Suite 200, Jacksonville, FL 32204-1177 | 2016-08-16 |
| 1407204845 | Angel Coffey | Nurse Practitioner | 915 W Monroe St, Suite 200, Jacksonville, FL 32204-1177 | 2016-05-26 |
| 1730534470 | Health Suite Inc | Internal Medicine | 915 W Monroe St, Suite 301, Jacksonville, FL 32204-1177 | 2016-05-02 |
| 1013375195 | Duval Vascular Center, LLC | Internal Medicine | 915 W Monroe St, Suite 100, Jacksonville, FL 32204-1177 | 2016-02-04 |
| 1992070585 | North East Florida Endocrine and Diabetes Assoc Pa | Durable Medical Equipment & Medical Supplies | 915 W Monroe St, Ste 200, Jacksonville, FL 32204-1177 | 2012-03-14 |
| 1467772780 | Gina Michelle Mele | Internal Medicine | 915 W Monroe St, Suite 301 Lavilla 2 Bldg., Jacksonville, FL 32204-1177 | 2010-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719853 | North Florida Surgeons, Pa | Orthopaedic Surgery | 2 Shirlciff Ways, Suite 300, Jacksonville, FL 32204 | 2019-06-18 |
| 1770043531 | Manuel Viado Rosas | Physical Therapist | Bold City Therapy and Wellness LLC, 2054 Park Street, Jacksonville, FL 32204 | 2019-03-20 |
| 1255805172 | Tracie Nickole Singh | Marriage & Family Therapist | 1125 W Beaver Street, Suite 205, Jacksonville, FL 32204 | 2019-01-14 |
| 1427548544 | Bold City Therapy and Wellness LLC | Clinic/Center | 2054 Park Street, Jacksonville, FL 32204 | 2018-05-14 |
| 1356883078 | Lcn Enterprise, LLC | Case Manager/Care Coordinator | 1225 W Beaver St Ste 106, Jacksonville, FL 32204 | 2016-11-11 |
| 1073065082 | Prosser and Prosser LLC | Non-emergency Medical Transport (VAN) | 2120 Ernest St, Jacksonville, FL 32204 | 2016-10-26 |
| 1336529817 | Nader Daoud | Internal Medicine | 1 Shircliffway, Jacksonville, FL 32204 | 2015-06-01 |
| 1194119214 | Benjamin James Dionne | Internal Medicine | 2 Shircliff Way Ste 400, Jacksonville, FL 32204 | 2015-03-26 |
| 1598187932 | Jamara Stephens | Counselor | 1225 W Beaver St Ste 205, Jacksonville, FL 32204 | 2014-01-18 |
| 1154743961 | Kathleen Jasper | Nurse Anesthetist, Certified Registered | 2165 Herschel Street, Jacksonville, FL 32204 | 2014-01-14 |
| Find all providers in zip 32204 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457321028 | Juan A Rosario-collazo | Dermatology | 4479 Baymeadows Rd, Jacksonville, FL 32217-4716 | 2006-01-25 |
| 1841825791 | Beal Dermatology, Pllc | Dermatology | 6817 Southpoint Pkwy Ste 101, Jacksonville, FL 32216-6285 | 2020-03-10 |
| 1801379409 | Bellavista Dermatology Group LLC | Dermatology | 3636 University Blvd S, Unit B2, Jacksonville, FL 32216 | 2018-09-10 |
| 1336553619 | Precision Dermatology and Skin Surgery Pa | Dermatology | 1550 Riverside Ave, Jacksonville, FL 32204-4161 | 2014-06-16 |
| 1437389772 | Leavitt Medical Associates of Florida Inc | Dermatology | 4100 Southpoint Dr E, Suite 1, Jacksonville, FL 32216-8017 | 2009-07-21 |
| 1942430285 | Leavitt Medical Associates of Florida Inc | Dermatology | 14810 Old Saint Augustine Rd, Suite 100, Jacksonville, FL 32258-2466 | 2009-07-21 |
| 1366672610 | Leavitt Medical Associates of Florida Inc | Dermatology | 14546 Old Saint Augustine Rd, Suite 407, Jacksonville, FL 32258-5468 | 2009-07-21 |
| 1508092347 | James Scott Trimble | Dermatology | 6890 Belfort Oaks Pl, Jacksonville, FL 32216-6241 | 2009-06-08 |
| 1598753717 | Henry Walter Randle | Dermatology | 4500 San Pablo Rd S, Jacksonville, FL 32224-1865 | 2005-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144827577 | Onspot-fl LLC. | Dermatology | 16461 Domestic Ave, Fort Myers, FL 33912-6008 | 2020-10-08 |
| 1942855150 | International Dermatology Research, Inc. | Dermatology | 8370 W Flagler St Ste 200, Miami, FL 33144-2038 | 2019-08-05 |
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1437517802 | Total Vein and Skin LLC | Dermatology | 10383 Hagen Ranch Road, Ste 100, Boynton Beach, FL 33437-3732 | 2016-02-01 |
| 1861812851 | Anand Haryani | Dermatology | 8745 N Us Highway 1, Sebastian, FL 32958-7524 | 2014-04-17 |
| 1164841797 | Michael Montuno | Dermatology | 38135 Market Sq Ste 108, Zephyrhills, FL 33542-7505 | 2014-04-10 |
| 1861813719 | Hillcrest Dermatology and Plastic Surgery P.a. | Dermatology | 733 Highway 466, Lady Lake, FL 32159-6340 | 2013-12-19 |
| 1922355957 | Florida Medical Specialists | Dermatology | 4351 Cortez Rd W, Suite 101, Bradenton, FL 34210 | 2012-08-09 |
| 1619232501 | Alliant Dermatology Pa | Dermatology | 8620 E County Road 466, The Villages, FL 32162-3670 | 2012-07-07 |
| 1114218328 | Leavitt Medical Assocaittes of Florida Inc | Dermatology | 1426 E Bloomindale Ave, Valrico, FL 33596 | 2011-04-21 |
| Find all providers with the same taxonomy | ||||
| City | JACKSONVILLE |
| Zip Code | 32204 |
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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.