Dermatology and Skin Cancer Surgery Center, LLC

Primary specialty

Plastic Surgery within the Head & Neck (Otolaryngology) PhysicianTaxonomy code 207YX0007X

Legal business name

DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC

Doing business as

Orlando Dermatology Center

Practice address

7560 Red Bug Lake Rd Ste 1014
Oviedo, FL 32765-6591

Phone

(407) 706-1770

Fax

(407) 706-1777

NPI assigned

May 1, 2018

Last updated

Dec 11, 2024By 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

Vitaly Blatnoy, MDNPI 1669462123

Title

Medical Director

Phone

(407) 446-8312

Specialties & licenses 2

Addresses

Other names 1

• Orlando Dermatology Center Doing business as

Locations

Practitioners 1

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.

• Vitaly Blatnoy, MD

  • Dermatology Physician
  • Oviedo, FL
  • NPI 1669462123
  NPD Authorized official

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733875200000",
    "number": "1134617533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 1014",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-706-1770",
            "fax_number": "407-706-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7560 RED BUG LAKE RD STE 1014",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327656591",
            "telephone_number": "407-706-1770",
            "fax_number": "407-706-1777"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4970 S US Highway 17/92",
            "address_purpose": "LOCATION",
            "city": "Casselberry",
            "state": "FL",
            "postal_code": "327073888",
            "country_code": "US",
            "telephone_number": "407-635-8012",
            "fax_number": "407-706-1777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "731 Strling Ctr Pl Unit 1931",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327465209",
            "country_code": "US",
            "telephone_number": "407-436-7380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 S Alafaya Trl Ste 26",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328288984",
            "country_code": "US",
            "telephone_number": "407-538-3855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-01",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A",
        "authorized_official_last_name": "BLATNOY",
        "authorized_official_first_name": "VITALY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "407-446-8312",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YX0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Dermatology Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Plastic Surgery within the Head & Neck (Otolaryngology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.