# ALLERGY DERMATOLOGY & SKIN CANCER CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386985950
- **Authorized official:** DR. GARY L MARDER D.O (PRESIDENT)
- **Authorized official phone:** (772) 335-1500

## Contact information

- **Practice address:** 9580 S FEDERAL HWY, PORT SAINT LUCIE, FL 34952-4217
- **Practice address phone:** (772) 335-1500
- **Mailing address:** 9580 S FEDERAL HWY, PORT SAINT LUCIE, FL 34952-4217
- **Mailing address phone:** (772) 335-1500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | OS4773 | FL | Yes |

## Other

- **Enumeration date:** 03/07/2013
- **Last updated:** 03/07/2013