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JACKSONVILLE SKIN CANCER CENTER, P.A.
NPI 1780861781
Dermatology - MOHS-Micrographic Surgery in Jacksonville, FL

Active since January 22, 2008CLIA 10D1007515 · Certificate of Compliance
4465 BAYMEADOWS RD STE 5, JACKSONVILLE, FL 32217(904) 737-0111(904) 737-4422 Get Directions Write a Review

NPPES record last updated: December 21, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jacksonville Skin Cancer Center, P.a. NPPES

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

JACKSONVILLE SKIN CANCER CENTER, P.A. (NPI 1780861781) is a healthcare organization registered as a mohs-micrographic surgery in Jacksonville, Florida and active in the NPI registry since January 2008. The organization holds a CLIA Certificate of Compliance certificate valid through January 5, 2027 and lists Michael Edward Lutz, President, as its authorized official.

NPPES Registry Identity

NPI1780861781
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameJACKSONVILLE SKIN CANCER CENTER, P.A.
Location Address4465 BAYMEADOWS RD STE 5Jacksonville, FL 32217-4727
Mailing Address4465 Baymeadows Rd Ste 5Jacksonville, FL 32217-4727 · (904) 737-0111 · Fax (904) 737-4422
Phone(904) 737-0111
Fax(904) 737-4422
Organization SubpartNo
Authorized OfficialMichael Edward LutzPresident · (904) 737-0111
Enumeration DateJanuary 22, 2008
Last NPPES UpdateDecember 21, 2012
✔ NPI 1780861781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
4465 BAYMEADOWS RD STE 5, Jacksonville, FL 32217
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Other Identifiers 3

Medicare PINDB9233FL
Other42484FL · Blue Cross Blue Shield
Medicare PINK5737FL

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

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.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 10D1007515

Jacksonville Skin Cancer Center PA · Jacksonville, FL
Active · expires Jan 5, 2027
CLIA Number10D1007515
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2025
Certificate Expiration DateJanuary 5, 2027
Laboratory DirectorMichael E. Lutz
Laboratory Phone(904) 737-0111
Laboratory LocationJacksonville Skin Cancer Center PA4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217
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

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

TAYLOR HUGHES APRN
Nurse Practitioner (Family)
4465 BAYMEADOWS RD STE 5
JACKSONVILLE, FL 32217
Duval County (813) 321-1786

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 Jacksonville Skin Cancer Center, P.A.'s NPI number?

The NPI number for Jacksonville Skin Cancer Center, P.A. is 1780861781. It was assigned to this organization in the NPPES registry on January 22, 2008.

Where is Jacksonville Skin Cancer Center, P.A. located?

Jacksonville Skin Cancer Center, P.A. is located at 4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217. The listed phone number is (904) 737-0111.

What is Jacksonville Skin Cancer Center, P.A.'s specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does Jacksonville Skin Cancer Center, P.A. hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D1007515) is associated with this NPI, valid through January 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Jacksonville Skin Cancer Center, P.A. accept?

Health plans from AvMed list Jacksonville Skin Cancer Center, 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 Jacksonville Skin Cancer Center, P.A. was last updated on December 21, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.