Organization Active NPI

On Site Dermatology LLC

  • Dermatology Physician
  • Boca Raton, FL
National Provider Identifier
1215978713
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ON SITE DERMATOLOGY LLC
Practice address
4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone
(877) 345-5300
NPI assigned
Jun 8, 2006
Last updated
Jan 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Authorized official

Name
Mr. Jeffrey Queen
Title
President
Phone
(561) 314-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 314-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NH, OH, DE, VA, DC6 enrollments

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
O20050830000722 FL Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 13 practitioners
O20130904000820 NH Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 7 practitioners
O20130920000571 OH Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 3 practitioners
Practice locations: Columbus, OH
O20150107000601 DE Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 4 practitioners
Practice locations: Wilmington, DE; Newark, DE; Hockessin, DE; Claymont, DE
O20150216000518 VA Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 5 practitioners
O20150521001562 DC Part B Supplier - Clinic/Group Practice 5991736837 Receives reassigned benefits from 6 practitioners
Practice locations: Fairfax, VA; Woodbridge, VA; Falls Church, VA; Fort Belvoir, VA; Great Falls, VA; Herndon, VA; Leesburg, VA; Lorton, VA…

National Provider Directory

National Provider Directory

Locations (25 of 76)

8000 Society Dr
#B
Claymont, DE 19703

501 S Harmony Rd
Newark, DE 19713
Phone (302) 266-9255

8279 E Club Rd
Boca Raton, FL 33433

902 Clint Moore Rd
#227
Boca Raton, FL 33487
Phone (516) 314-2000

1714 14th St W
Bradenton, FL 34205

6101 Pointe West Blvd
Bradenton, FL 34209
Phone (941) 795-5533

121 NE 10th Pl
Cape Coral, FL 33909

1318 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 288-8502

1435 Santa Barbara Blvd
Cape Coral, FL 33991

1906 Skyline Blvd
Cape Coral, FL 33991
Phone (989) 598-7822

831 Santa Barbara Blvd
Cape Coral, FL 33991
Phone (239) 237-3124

1100 Ponce de Leon Blvd
Clearwater, FL 33756
Phone (727) 240-2837

2425 N McMullen Booth Rd
Clearwater, FL 33759
Phone (727) 758-7945

2701 Regency Oaks Blvd
Clearwater, FL 33759
Phone (727) 288-2345

2794 S Flamingo Rd
Davie, FL 33330
Phone (754) 216-8743

252 Forest Lake Blvd
Daytona Beach, FL 32119
Phone (386) 304-7842

7255 Strive Pl
Fern Park, FL 32730
Phone (407) 848-1743

8351 College Pkwy
Fort Myers, FL 33919
Phone (239) 201-2252

5190 E 8th Ave
Hialeah, FL 33013
Phone (305) 685-5136

1835 Wilson St
Hollywood, FL 33020
Phone (561) 960-2020

550 Hope Cir
Immokalee, FL 34142

12350 San Jose Blvd
Jacksonville, FL 32223
Phone (904) 252-3357

14199 Wm Davis Pkwy
Jacksonville, FL 32224
Phone (904) 821-9900

5760 Timuquana Rd
Jacksonville, FL 32210
Phone (904) 701-7227

601 N Newnan St
Jacksonville, FL 32202

Practitioners & affiliated clinicians

Practitioners 75

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.

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769040000000",
    "number": "1215978713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-314-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "877-345-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON SITE DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A",
        "authorized_official_last_name": "QUEEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-314-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2026; 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.