Provider Demographics
NPI:1811062086
Name:A CENTER FOR DERMATOLOGY PA
Entity type:Organization
Organization Name:A CENTER FOR DERMATOLOGY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:E
Authorized Official - Last Name:SKOPIT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:954-894-1616
Mailing Address - Street 1:3990 SHERIDAN STREET
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-3655
Mailing Address - Country:US
Mailing Address - Phone:954-894-1616
Mailing Address - Fax:954-894-9906
Practice Address - Street 1:3990 SHERIDAN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3655
Practice Address - Country:US
Practice Address - Phone:954-894-1616
Practice Address - Fax:954-894-5425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
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
40637AMedicare ID - Type Unspecified
FL40637Medicare ID - Type Unspecified