Provider Demographics
NPI:1497359426
Name:DERMATOLOGY CENTER OF THE PALM BEACHES PA
Entity Type:Organization
Organization Name:DERMATOLOGY CENTER OF THE PALM BEACHES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHECTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:561-968-7546
Mailing Address - Street 1:5808 S JOG RD
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-6511
Mailing Address - Country:US
Mailing Address - Phone:561-968-7546
Mailing Address - Fax:561-968-1143
Practice Address - Street 1:5808 S JOG RD
Practice Address - Street 2:
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-6511
Practice Address - Country:US
Practice Address - Phone:561-968-7546
Practice Address - Fax:561-968-1143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2024-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty