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General NPI Number Information
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NPI Number | 1558315234
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Entity Type | Organization
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Legal Business Name | SAND LAKE DERMATOLOGY CENTER, P.A.
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Dates
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Enumeration Date | 05/19/2006
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 7335 W SAND LAKE RD SUITE 200
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City | ORLANDO
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State | FL
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Zip | 32819-5538
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Country | US
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Telephone | 407-352-8553
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Fax | 407-351-8412
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Provider Business Mailing Address
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Address Line | 7335 W SAND LAKE RD SUITE 200
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City | ORLANDO
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State | FL
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Zip | 32819-5538
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Country | US
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Telephone | 407-352-8553
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Fax | 407-351-8412
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Authorized Official
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Title or Position | OWNER
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Name | DR. ALLISON KAY ARTHUR
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Credential | M.D.
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Telephone | 407-352-8553
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | ME0050669
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License Number State | FL
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