Proctor Dermatology & Skin Surgery PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PROCTOR DERMATOLOGY & SKIN SURGERY PA

Practice address

1609 Pasadena Ave S
Suite 4 0
South Pasadena, FL 33707-4565

Phone

(727) 345-8050

Fax

(727) 345-4344

NPI assigned

Sep 26, 2007

Last updated

Feb 21, 2008By 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

Dr. Michael Scott Proctor, MD

Title

President

Phone

(727) 345-8050

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203552000000",
    "number": "1780871491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1609 PASADENA AVE S",
            "address_2": "SUITE 4 0",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074565",
            "telephone_number": "727-345-8050",
            "fax_number": "727-345-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 PASADENA AVE S",
            "address_2": "SUITE 4 0",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074565",
            "telephone_number": "727-345-8050",
            "fax_number": "727-345-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCTOR DERMATOLOGY & SKIN SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-02-21",
        "status": "A",
        "authorized_official_last_name": "PROCTOR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-345-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in South Pasadena, FL
• Providers in South Pasadena, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; 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.