Sca Dermatology, LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

SCA DERMATOLOGY, LLC

Practice address

915 W Monroe St
S. 101
Jacksonville, FL 32204-1177

Phone

(904) 903-4345

NPI assigned

Mar 16, 2012

Organization subpart

Yes

Parent organization

SKIN AND CANCER ASSOCIATES, LLPAs reported in NPPES

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

Authorized official

Name

Richard S, Greene

Title

MD / President

Phone

(954) 473-6750

Specialties & licenses 1

Addresses

Part of

Skin and Cancer Associa

Locations

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

{
    "created_epoch": "1331856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489449600000",
    "number": "1518232065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 PARK CENTRE BLVD",
            "address_2": "S. 300",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695365",
            "telephone_number": "305-623-5595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 W MONROE ST",
            "address_2": "S. 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322041177",
            "telephone_number": "904-903-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCA DERMATOLOGY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SKIN AND CANCER ASSOCIATES, LLP",
        "enumeration_date": "2012-03-16",
        "last_updated": "2017-03-14",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "S,",
        "authorized_official_title_or_position": "MD / PRESIDENT",
        "authorized_official_telephone_number": "954-473-6750"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jericho B Sayoc, O.D.
• Jerry Wayne Sayre, M.D.
• SB Opco LLC
• Amer Sbeih, DMD
• Firas Sbeih, MD
• Mary Scaduto, MD
• Erin M Scales, MD
• Jetia Lasonja Scales, AGNP-C
• Bridget Scanlan
• Catherine Scanlon, MSN, CRNA

• MOHS-Micrographic Surgery Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.