# DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Orlando Dermatology Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134617533
- **Authorized official:** VITALY BLATNOY MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (407) 446-8312

## Contact information

- **Practice address:** 7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
- **Practice address phone:** (407) 706-1770
- **Practice address fax:** (407) 706-1777
- **Mailing address:** 7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
- **Mailing address phone:** (407) 706-1770
- **Mailing address fax:** (407) 706-1777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207N00000X | Dermatology Physician | — | NULL | — |
| 207N00000X | Dermatology Physician | — | — | — |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2018
- **Last updated:** 12/11/2024