Skin Local Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN LOCAL DERMATOLOGY LLC

Practice address

13615 S Dixie Hwy Ste 116
Palmetto Bay, FL 33176-7254

Phone

(786) 701-8106

Fax

(844) 847-2493

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Jennifer Martinez, PA

Title

Owner

Phone

(786) 701-8106

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713312000000",
    "number": "1598519332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13615 S DIXIE HWY STE 116",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767254",
            "telephone_number": "786-701-8106",
            "fax_number": "844-847-2493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13615 S DIXIE HWY STE 116",
            "city": "PALMETTO BAY",
            "state": "FL",
            "postal_code": "331767254",
            "telephone_number": "786-701-8106",
            "fax_number": "844-847-2493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN LOCAL DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "786-701-8106",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Palmetto Bay, FL
• Providers in Palmetto Bay, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 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.