Florida Dermatology and Skin Cancer Specialists PL

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FLORIDA DERMATOLOGY AND SKIN CANCER SPECIALISTS PL

Practice address

870 77TH Ave N Ste 1
St Petersburg, FL 33702-5240

Phone

(727) 821-3600

Fax

(727) 821-3611

NPI assigned

Aug 2, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Michael A Scannon, MDNPI 1396734851

Title

President

Phone

(813) 877-4811

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Margaret Ann Kelleher, M.D.

  • Dermatology Physician
  • St Petersburg, FL
  • NPI 1841240462
  Medicare reassignment NPD
• Casey T Woods, P.A.-C

  • Medical Physician Assistant
  • St Petersburg, FL
  • NPI 1063738557
  Medicare reassignment
• Michael A Scannon, M.D.

  • Procedural Dermatology Physician
  • Tampa, FL
  • NPI 1396734851
  Authorized official Same address or phone

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715904000000",
    "number": "1093061582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "870 77TH AVE N STE 1",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025240",
            "telephone_number": "727-821-3600",
            "fax_number": "727-821-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 77TH AVE N STE 1",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025240",
            "telephone_number": "727-821-3600",
            "fax_number": "727-821-3611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DERMATOLOGY AND SKIN CANCER SPECIALISTS PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2024-05-17",
        "certification_date": "2024-05-17",
        "status": "A",
        "authorized_official_last_name": "SCANNON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-877-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "10D1075937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DT3661",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.