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

Florida Center for Dermatology, PA

Organization Dermatology Physician · NPI 1073870341

Florida Center for Dermatology, PA provides Dermatology Physician services in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2012.

Licensed in
FL
In the registry since
2012
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

105 Southpark Blvd Ste A103
St Augustine, FL 32086-5191 Not confirmed with CMS for 14 years — call before visiting
Phone: (904) 342-7765
Fax: (904) 342-7770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence ME92201 (FL)

Record details

NPI number1073870341
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jonathan Kantor — President · (904) 342-7765
NPI enumeratedApril 11, 2012
Last updated in NPPESApril 11, 2012
Mailing address105 Southpark Blvd, Suite A103, St Augustine, FL 32086-5191

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