Healthcare Provider Details

I. General information

NPI: 1952326894
Provider Name (Legal Business Name): SARASOTA SKIN AND CANCER CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 10/25/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2179 S TAMIAMI TRL SUITE 101
OSPREY FL
34229
US

IV. Provider business mailing address

2179 S TAMIAMI TRAIL SUITE 101
OSPREY FL
34229
US

V. Phone/Fax

Practice location:
  • Phone: 941-966-0222
  • Fax: 941-966-5100
Mailing address:
  • Phone: 941-966-0222
  • Fax: 941-966-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. STEPHANIE A CARADONNA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 941-966-0222