Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacksonville Skin Cancer Center, PA

Organization Dermatology Physician · NPI 1780861781

Jacksonville Skin Cancer Center, PA is a Dermatology Physician in Jacksonville, Florida. Registered with an NPI since 2008.

In the registry since
2008
Specialties on file
4
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4465 Baymeadows Rd Ste 5
Jacksonville, FL 32217-4727
Phone: (904) 737-0111
Fax: (904) 737-4422
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X
Dermatology Physician Taxonomy 207N00000X
Dermatopathology Physician Taxonomy 207ND0900X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1780861781
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michael Lutz — President · (904) 737-0111
NPI enumeratedJanuary 22, 2008
Last updated in NPPESDecember 21, 2012
Mailing address4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217-4727

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