Healthcare Provider Details

I. General information

NPI: 1497709489
Provider Name (Legal Business Name): SKIN CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 GLADES RD SUITE 210
BOCA RATON FL
33431-7205
US

IV. Provider business mailing address

1901 BUTTERFIELD RD SUITE 220
DOWNERS GROVE IL
60515-7915
US

V. Phone/Fax

Practice location:
  • Phone: 561-750-2130
  • Fax: 561-367-6170
Mailing address:
  • Phone: 630-725-2700
  • Fax: 630-725-2783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER PEREZ
Title or Position: OWNER
Credential: MD
Phone: 561-472-4605