Provider Demographics
NPI:1285661710
Name:DERMATOLOGY SPECIALISTS OF NORTH FLORIDA, P.A.
Entity type:Organization
Organization Name:DERMATOLOGY SPECIALISTS OF NORTH FLORIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:KARTSONIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:904-731-1770
Mailing Address - Street 1:7711 BAYMEADOWS RD E STE 6
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9110
Mailing Address - Country:US
Mailing Address - Phone:904-731-1770
Mailing Address - Fax:904-996-8300
Practice Address - Street 1:7711 BAYMEADOWS RD E STE 6
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9110
Practice Address - Country:US
Practice Address - Phone:904-731-1770
Practice Address - Fax:904-996-8300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK9975Medicare PIN
FL02754WMedicare UPIN
FLD20781Medicare UPIN