Provider Demographics
NPI:1285975607
Name:FLORIDA SKIN CENTER
Entity type:Organization
Organization Name:FLORIDA SKIN CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAIS
Authorized Official - Middle Name:AURORA
Authorized Official - Last Name:BADIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, DO
Authorized Official - Phone:239-561-3376
Mailing Address - Street 1:13691 METROPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4318
Mailing Address - Country:US
Mailing Address - Phone:239-561-3376
Mailing Address - Fax:239-561-3020
Practice Address - Street 1:4037 DEL PRADO BLVD S
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33904-7162
Practice Address - Country:US
Practice Address - Phone:239-561-3376
Practice Address - Fax:239-561-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site