Organization
JACKSONVILLE SKIN CANCER CENTER, P.A.
Active
Organization
JACKSONVILLE SKIN CANCER CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL EDWARD LUTZ M.D. (PRESIDENT)
(904) 737-0111
Entity
Organization
Contact information
Practice address
4465 BAYMEADOWS RD STE 5, JACKSONVILLE, FL 32217-4727
(904) 737-0111
(904) 737-4422
Mailing address
4465 BAYMEADOWS RD STE 5, JACKSONVILLE, FL 32217-4727
(904) 737-0111
(904) 737-4422
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
207ND0900X
Dermatopathology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42484
BLUE CROSS BLUE SHIELD
FL
Enumeration date
01/22/2008
Last updated
12/21/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up