Organization
DERMATOLOGY AND SKIN CANCER SURGERY CENTER, LLC
Active
Other names
Orlando Dermatology Center
Organization subpart
No
Provider details
NPI number
Authorized official
VITALY BLATNOY MD (OWNER)
(407) 706-1770
Entity
Organization
Contact information
Practice address
7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
(407) 706-1770
Mailing address
7560 RED BUG LAKE RD STE 1014, OVIEDO, FL 32765-6591
(407) 706-1770
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001633600
—
FL
Enumeration date
08/18/2016
Last updated
07/12/2024
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