Provider Demographics
NPI:1548501950
Name:ADVANCEDERMATOLOGY AND SKIN CANCER CENTER, PSC
Entity type:Organization
Organization Name:ADVANCEDERMATOLOGY AND SKIN CANCER CENTER, PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:VALENTIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FAAD
Authorized Official - Phone:787-945-6546
Mailing Address - Street 1:59 CALLE KINGS CT APT 904
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00911-1167
Mailing Address - Country:US
Mailing Address - Phone:787-945-6546
Mailing Address - Fax:787-945-6571
Practice Address - Street 1:150 AVE JOSE DE DIEGO SAN JUAN HEALTH CENTRE
Practice Address - Street 2:SUITE 601
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00907
Practice Address - Country:US
Practice Address - Phone:787-945-6546
Practice Address - Fax:787-945-6571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-11
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR16842207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty