Healthcare Provider Details

I. General information

NPI: 1740737576
Provider Name (Legal Business Name): SKIN AND CANCER ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

261 N UNIVERSITY DR STE 720
PLANTATION FL
33324-2009
US

IV. Provider business mailing address

261 N UNIVERSITY DR STE 720
PLANTATION FL
33324-2009
US

V. Phone/Fax

Practice location:
  • Phone: 954-473-6750
  • Fax:
Mailing address:
  • Phone: 305-623-5595
  • Fax: 305-623-9264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number
License Number State

VIII. Authorized Official

Name: REUVEN PORGES
Title or Position: CEO
Credential: MD
Phone: 305-623-5595