MEDICARE: SKIN HEALTH CENTER DERMATOLOGY AND MOHS SURGERY PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62810	OTHER	FL	BLUE CROSS ID NUMBER

General Provider Information

NPI Number	:	1801973037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SKIN HEALTH CENTER DERMATOLOGY AND MOHS SURGERY PA

Provider Business Mailing Address
First Line	:	3231 GULF GATE DR
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34231-2406
Country	:	US
Telephone Number	:	941-924-1193
Fax Number	:	941-922-0858

Provider Business Practice Location Address
First Line	:	3231 GULF GATE DR
Second Line	:	SUITE 101
City	:	SARASOTA
State	:	FL
Zip	:	34231-2406
Country	:	US
Telephone Number	:	941-924-1193
Fax Number	:	941-922-0858

Authorized Official
Title or Position	:	OWNER
Name	:	NADIA S URATO
Credential	:	MD
Telephone Number	:	941-924-1193

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	08/22/2020

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Directions to “SKIN HEALTH CENTER DERMATOLOGY AND MOHS SURGERY PA ” Practice Location

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