Provider Demographics
NPI:1801973037
Name:SKIN HEALTH CENTER DERMATOLOGY AND MOHS SURGERY PA
Entity type:Organization
Organization Name:SKIN HEALTH CENTER DERMATOLOGY AND MOHS SURGERY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:URATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:941-924-1193
Mailing Address - Street 1:3231 GULF GATE DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-2406
Mailing Address - Country:US
Mailing Address - Phone:941-924-1193
Mailing Address - Fax:941-922-0858
Practice Address - Street 1:3231 GULF GATE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-2406
Practice Address - Country:US
Practice Address - Phone:941-924-1193
Practice Address - Fax:941-922-0858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL62810OtherBLUE CROSS ID NUMBER