Sanctuary Medical Aesthetic Center of Boca Raton LLC
NPI 1104282714ActiveOrganization· Dermatology· Boca Raton, FL
Dermatology in Boca Raton, Florida, registered in NPPES in January 2016. The authorized official on file is Jeff Davis, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1104282714 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 12, 2016 |
| Last updated in NPPES | May 20, 2016 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (FL) |
|---|
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