Provider Demographics
NPI:1003004862
Name:VIRGINIA ANN SCHEKORRA PA
Entity Type:Organization
Organization Name:VIRGINIA ANN SCHEKORRA PA
Other - Org Name:THE DERMATOLOGY CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHEKORRA
Authorized Official - Suffix:
Authorized Official - Credentials:DO, PA
Authorized Official - Phone:727-548-9196
Mailing Address - Street 1:6020 PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33781-3228
Mailing Address - Country:US
Mailing Address - Phone:727-548-9196
Mailing Address - Fax:727-545-4678
Practice Address - Street 1:6020 PARK BLVD
Practice Address - Street 2:
Practice Address - City:PINELLAS PARK
Practice Address - State:FL
Practice Address - Zip Code:33781-3228
Practice Address - Country:US
Practice Address - Phone:727-548-9196
Practice Address - Fax:727-545-4678
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0005747207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1522OtherMEDICARE GROUP #