Skin Care Specialists LLC

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

D09546 Issued in MD

Legal business name

SKIN CARE SPECIALISTS LLC

Practice address

14959 Old Frederick Rd
Woodbine, MD 21797-8613

Phone

(410) 489-6249

Fax

(206) 350-5127

NPI assigned

Dec 3, 2010

Last updated

Dec 6, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ivens C Leflore, MD

Title

Owner

Phone

(410) 489-6249

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291593600000",
    "number": "1043512502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14959 OLD FREDERICK RD",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217978613",
            "telephone_number": "410-489-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14959 OLD FREDERICK RD",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217978613",
            "telephone_number": "410-489-6249",
            "fax_number": "206-350-5127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN CARE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-03",
        "last_updated": "2010-12-06",
        "status": "A",
        "authorized_official_last_name": "LEFLORE",
        "authorized_official_first_name": "IVENS",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-489-6249",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D09546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.