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FLORIDA CENTER FOR DERMATOLOGY, P.A.
NPI 1073870341
Dermatology in St Augustine, FL

Active since April 11, 2012CLIA Certified · 2 labs
105 SOUTHPARK BLVD, SUITE A103, ST AUGUSTINE, FL 32086(904) 342-7765(904) 342-7770 Get Directions Write a Review

NPPES record last updated: April 11, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Florida Center For Dermatology, P.a. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FLORIDA CENTER FOR DERMATOLOGY, P.A. (NPI 1073870341) is a healthcare organization registered as a dermatology in St Augustine, Florida and active in the NPI registry since April 2012. The organization holds 2 active CLIA laboratory certificates and lists Jonathan Kantor, President, as its authorized official.

NPPES Registry Identity

NPI1073870341
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameFLORIDA CENTER FOR DERMATOLOGY, P.A.
Location Address105 SOUTHPARK BLVD, SUITE A103St Augustine, FL 32086-5191
Mailing Address105 Southpark Blvd, Suite A103St Augustine, FL 32086-5191 · (904) 342-7765 · Fax (904) 342-7770
Phone(904) 342-7765
Fax(904) 342-7770
Organization SubpartNo
Authorized OfficialJonathan KantorPresident · (904) 342-7765
Enumeration DateApril 11, 2012
✔ NPI 1073870341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in FL · ME92201
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
105 SOUTHPARK BLVD, St Augustine, FL 32086
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Florida Center For Dermatology, P.a. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Florida Center For Dermatology, P.A., which bills Medicare for the services this clinician delivers.

Clinician (1)

Jonathan Kantor, MD
Dermatology
NPI 1326038886
3400 SPRUCE ST
Philadelphia, PA 19104
(215) 662-2737
✔ PECOS✔ Accepts Medicare777 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2299323

Florida Center For Dermatology Laboratory II · Jacksonville, FL
Active · expires Jan 16, 2027
CLIA Number10D2299323
Laboratory TypePhysician Office
Certificate Effective DateJanuary 17, 2025
Certificate Expiration DateJanuary 16, 2027
Laboratory DirectorJonathan Kantor
Laboratory Phone(904) 342-7765
Laboratory LocationFlorida Center For Dermatology Laboratory II3 Shircliff Way Suite 630, Jacksonville, FL 32204
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 10D2043829

Florida Center For Dermatology Laboratory · Saint Augustine, FL
Active · expires Nov 14, 2026
CLIA Number10D2043829
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2024
Certificate Expiration DateNovember 14, 2026
Laboratory DirectorJonathan Kantor
Laboratory Phone(904) 342-7765
Laboratory LocationFlorida Center For Dermatology Laboratory1301 Plantation Island Dr South Ste 106B, Saint Augustine, FL 32080
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Florida Center For Dermatology, P.A.'s NPI number?

The NPI number for Florida Center For Dermatology, P.A. is 1073870341. It was assigned to this organization in the NPPES registry on April 11, 2012.

Where is Florida Center For Dermatology, P.A. located?

Florida Center For Dermatology, P.A. is located at 105 Southpark Blvd Suite A103, St Augustine, FL 32086. The listed phone number is (904) 342-7765.

What is Florida Center For Dermatology, P.A.'s specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Florida Center For Dermatology, P.A. enrolled in Medicare?

Yes. Florida Center For Dermatology, P.A. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Florida Center For Dermatology, P.A.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Florida Center For Dermatology, P.A.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Florida Center For Dermatology, P.A. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Florida Center For Dermatology, P.A. accept?

Health plans from AvMed list Florida Center For Dermatology, P.A. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Florida Center For Dermatology, P.A. was last updated on April 11, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.