Allergy Dermatology & Skin Cancer Center Inc

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

OS4773 Issued in FL

Legal business name

ALLERGY DERMATOLOGY & SKIN CANCER CENTER INC

Practice address

9580 S Federal Hwy
Port Saint Lucie, FL 34952-4217

Phone

(772) 335-1500

NPI assigned

Mar 7, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Gary L Marder, D.O

Title

President

Phone

(772) 335-1500

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Bock

  • Physician Assistant
  • Port St Lucie, FL
  • NPI 1578671491
  NPD (past)
• Alyssa Ostby Coutts, PA-C

  • Physician Assistant
  • Vero Beach, FL
  • NPI 1922470434
  NPD (past)

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

{
    "created_epoch": "1362614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362614400000",
    "number": "1386985950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9580 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524217",
            "telephone_number": "772-335-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9580 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349524217",
            "telephone_number": "772-335-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY DERMATOLOGY & SKIN CANCER CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-07",
        "last_updated": "2013-03-07",
        "status": "A",
        "authorized_official_last_name": "MARDER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "772-335-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "OS4773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allcare Health & Human Services, Inc
• Alyssa Danielle Allem, MD
• Alysha Allen
• Bylsma Lea Allen, MD
• Nakkia Allen
• Hope J Allison, MS
• Hans Almanzar, DDS
• Aloha Home Care, LLC
• Mayra Liset Alonso, MD
• Amslie Nagetha Alsaint

• Medical Specialty Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Medical Specialty Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2013; 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.