Provider Demographics
NPI:1952326894
Name:SARASOTA SKIN AND CANCER CENTER INC
Entity Type:Organization
Organization Name:SARASOTA SKIN AND CANCER CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARADONNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-966-0222
Mailing Address - Street 1:2179 S TAMIAMI TRAIL
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229
Mailing Address - Country:US
Mailing Address - Phone:941-966-0222
Mailing Address - Fax:941-966-5100
Practice Address - Street 1:2179 S TAMIAMI TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229
Practice Address - Country:US
Practice Address - Phone:941-966-0222
Practice Address - Fax:941-966-5100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK4796Medicare ID - Type Unspecified