SANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC
NPI 1104282714
Dermatology in Boca Raton, FL

Active since January 12, 2016CLIA 10D2141186 · Certificate of Compliance
4800 N FEDERAL HWY, SUITE C100, BOCA RATON, FL 33431(561) 886-0970 Get Directions Write a Review

NPPES record last updated: May 20, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 20, 2016, Jan 12, 2016 (2 updates tracked since 2016).

About Sanctuary Medical Aesthetic Center Of Boca Raton Llc NPPES

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

SANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC (NPI 1104282714) is a healthcare organization registered as a dermatology in Boca Raton, Florida and active in the NPI registry since January 2016. The organization holds a CLIA Certificate of Compliance certificate valid through January 15, 2028 and lists Jeff Davis, Ceo, as its authorized official.

NPPES Registry Identity

NPI1104282714
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameSANCTUARY MEDICAL AESTHETIC CENTER OF BOCA RATON LLC
Location Address4800 N FEDERAL HWY, SUITE C100Boca Raton, FL 33431-5188
Mailing Address4800 N Federal Hwy, Suite C100Boca Raton, FL 33431-5188 · (561) 886-0970
Organization SubpartNo
Authorized OfficialJeff DavisCeo · (561) 430-6644
Enumeration DateJanuary 12, 2016
Last NPPES UpdateMay 20, 20162 updates tracked since enumeration
NPI 1104282714 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
4800 N FEDERAL HWY, Boca Raton, FL 33431

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 MULTIPLE SINGLE SPECIALTY GROUP

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

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 10D2141186

Sanctuary Medical Aesthetic Center Of Boca Raton LLC · Boca Raton, FL
Active · expires Jan 15, 2028
CLIA Number10D2141186
Laboratory TypePhysician Office
Certificate Effective DateJanuary 16, 2026
Certificate Expiration DateJanuary 15, 2028
Laboratory DirectorKathleen Herne
Laboratory Phone(561) 886-0970
Laboratory LocationSanctuary Medical Aesthetic Center Of Boca Raton LLC4800 N Federal Hwy C100, Boca Raton, FL 33431
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
4800 N FEDERAL HWY, A205
BOCA RATON, FL 33431
Specialist
4800 N FEDERAL HWY, C101
BOCA RATON, FL 33431
Psychiatry & Neurology (Psychiatry)
4800 N FEDERAL HWY, E 102
BOCA RATON, FL 33431
Plastic Surgery
4800 N FEDERAL HWY, SUITE C101
BOCA RATON, FL 33431
Specialist
4800 N FEDERAL HWY, C101
BOCA RATON, FL 33431
Psychiatry & Neurology (Psychiatry)
4800 N FEDERAL HWY, SUITE 102E
BOCA RATON, FL 33431
Acupuncturist
4800 N FEDERAL HWY, SUITE D304
BOCA RATON, FL 33431
Massage Therapist
4800 N FEDERAL HWY, 301E
BOCA RATON, FL 33431

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 Sanctuary Medical Aesthetic Center Of Boca Raton LLC's NPI number?

The NPI number for Sanctuary Medical Aesthetic Center Of Boca Raton LLC is 1104282714. It was assigned to this organization in the NPPES registry on January 12, 2016.

Where is Sanctuary Medical Aesthetic Center Of Boca Raton LLC located?

Sanctuary Medical Aesthetic Center Of Boca Raton LLC is located at 4800 N Federal Hwy Suite C100, Boca Raton, FL 33431. The listed phone number is (561) 886-0970.

What is Sanctuary Medical Aesthetic Center Of Boca Raton LLC's specialty?

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

Does Sanctuary Medical Aesthetic Center Of Boca Raton LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2141186) is associated with this NPI, valid through January 15, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sanctuary Medical Aesthetic Center Of Boca Raton LLC accept?

Health plans from Florida Blue (BlueCross BlueShield FL) list Sanctuary Medical Aesthetic Center Of Boca Raton LLC 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 Sanctuary Medical Aesthetic Center Of Boca Raton LLC was last updated on May 20, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.