Healthcare Provider Details

I. General information

NPI: 1447561303
Provider Name (Legal Business Name): PHYLLIS SKOLNIK MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2010
Last Update Date: 02/23/2023
Certification Date: 02/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 N KENDALL DR STE 101
MIAMI FL
33176-2209
US

IV. Provider business mailing address

8740 N KENDALL DR STE 101
MIAMI FL
33176-2209
US

V. Phone/Fax

Practice location:
  • Phone: 305-661-8978
  • Fax: 305-661-0193
Mailing address:
  • Phone: 305-661-8978
  • Fax: 305-661-0193

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: PHYLLIS SKOLNIK
Title or Position: PRESIDENT
Credential: MD
Phone: 305-661-8978