Suncoast Dermatology and Skin Surgery Center, PA

NPI #1902890239 in Lecanto, Florida

Provider Information

NPI Number: 1902890239
Entity Type: Organization
Organization Name: Suncoast Dermatology and Skin Surgery Center, PA
Primary Specialty: Dermatology
Enumeration Date: Sep 1, 2005
Last Updated: Nov 15, 2011

Practice Location

Address: 525 N DACIE PT
City: Lecanto
State: Florida
ZIP Code: 34461-8399
Phone: (352) 746-2200

Authorized Official

Name: DR. RALPH EUGENE MASSULLO JR., MD
Title: PRESIDENT
Phone: (352) 746-2200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Dermatology - Dermatopathology — Dermatopathology	207ND0900X
Dermatology - Procedural Dermatology — Procedural Dermatology	207NS0135X
Dermatology	207N00000X	Primary

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