Sanders Dermatology and Skin Cancer Center,LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

87851 Issued in FL

Legal business name

SANDERS DERMATOLOGY AND SKIN CANCER CENTER,LLC

Practice address

1155 35TH LN
Suite 202
Vero Beach, FL 32960-6521

Phone

(772) 778-7782

Fax

(772) 778-7879

NPI assigned

Jan 18, 2012

Organization subpart

No

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

Authorized official

Name

Jonathan Scott Sanders, M.D.

Title

Managing Member

Phone

(772) 778-7782

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326844800000",
    "number": "1871864264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 35TH LN",
            "address_2": "SUITE 202",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606521",
            "telephone_number": "772-778-7782",
            "fax_number": "772-778-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 35TH LN",
            "address_2": "SUITE 202",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329606521",
            "telephone_number": "772-778-7782",
            "fax_number": "772-778-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDERS DERMATOLOGY AND SKIN CANCER CENTER,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A",
        "authorized_official_last_name": "SANDERS",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "772-778-7782",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "FL",
            "license": "87851",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "FL",
            "license": "87851",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Samson, RD, LD/N
• Samantha Sanabria
• Fulvio L Sanchez, PT
• Theresa Ryan Sanchez
• Victoria Ann Sanden, MPT
• Jonathan Sanders, MD JD
• Prabhdeep Kaur Sandhu
• Madison Nicole Santa Maria, PTA
• Lindsay Nicole Santeramo
• Genesis Santiago-Alvarez, DMD

• Dermatology Physician in Vero Beach, FL
• Providers in Vero Beach, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.