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SUNCOAST SKIN SOLUTIONS NPI 1487827416


NPI Information

NPI: 1487827416
Provider Name: SUNCOAST SKIN SOLUTIONS
Classification: Dermatology - 207NS0135X
Entity Type: Organization

Specialization: Procedural Dermatology

CLIA Number: 10D2250851

Address:
4651 VAN DYKE RD
LUTZ, FL
ZIP 33558
Phone: (813) 321-1786
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SUNCOAST SKIN SOLUTIONS is a procedural dermatology dermatology in Lutz, FL. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). SUNCOAST SKIN SOLUTIONS NPI is 1487827416. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4651 VAN DYKE RD
LUTZ, FL
ZIP 33558-880
Phone: (813) 321-1786
Fax: (813) 321-1787

The provider's authorized official is Christopher David Ewanowski .
The authorized official title is Medical Director and has the following contact phone number (813) 321-1786.

The CLIA number assigned to this NPI record is 10D2250851 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 4/10/2008 and was last updated on 3/1/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural DermatologyME100378FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001793700MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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