Physician-Led Dermatology Practice, 24-Year Greater Orlando Clinic

$1.1M

Revenue

$593K

SDE

1.3x

Multiple

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Full Editorial Writeup

This is an established medical and cosmetic dermatology practice in the Greater Orlando area, operating since 2001 and built over two decades on physician referrals and word of mouth. A single board-certified dermatologist currently sees patients roughly 22 hours a week across a four-day schedule, generating $1,142,780 in 2025 revenue and $592,712 in normalized SDE. The service mix is procedure-driven: skin cancer screening, biopsies, cryosurgery, about two surgical excisions a day with repair, patch testing, chronic disease management, plus cash-pay cosmetics like Botox, fillers, Morpheus8, and PRP hair restoration.

The practice runs out of a 3,100 square foot leased ground-floor suite with four procedure-capable exam rooms and space for at least one more provider. Billing is outsourced and the EMR is cloud-based, which makes it an easy bolt-on for a group or PE platform. Roughly half the patient base is Medicare skin-cancer surveillance patients who return annually, giving the revenue a durable, recurring character. Medicaid is not accepted.

What makes this notable is the mismatch between a high-margin, physician-only clinic and a 1.27x asking multiple. The low price reflects a deliberate downsizing to a single part-time physician and the owner's retirement. The seller offers a 6 to 12 month transition and a $150,000 seller note to a qualified physician buyer, so the headline opportunity is simply re-loading an under-utilized asset: more clinical hours, a rebuilt cosmetic program, restarted marketing, and recovered no-show slots.

Why we like it

Earnings quality is the headline: $592,712 SDE on $1,142,780 revenue is a 52% owner-earnings margin, which is exceptional for a medical practice. The seller discloses the SDE is normalized to include market rent, so the margin is not propped up by free facilities. Cosmetic services are paid at time of service, adding clean cash-pay revenue on top of insured medical work.
Durability runs deep here: 24 years in the same community with a referral-driven base, and about half the patients are Medicare skin-cancer surveillance cases that return every single year. Skin cancer screening and chronic disease management are not discretionary, so the medical core holds up through downturns. The cash-pay cosmetic layer is the only cyclical slice, and it is a minority of revenue.
The market tailwind is real and measurable: roughly 875,000 people live within 10 miles of the office in one of Florida's fastest-growing metros, with population projected to grow about 9% by 2030. Nationally there is only one dermatologist per 26,500 people and new-patient waits of four months are common, so demand outstrips supply. Local competition leans on mid-level providers, leaving physician-only care as a genuine differentiator.
The operator advantage is almost embarrassingly obvious: the owner works four days a week, five to six patient hours a day, so a full-time dermatologist can roughly double clinical hours in the same fully staffed space. The price explicitly reflects a revenue decline from downsizing to one part-time physician, meaning the buyer is paying for a shrunken run-rate on an asset built for two to three providers. Every added hour is incremental margin against fixed overhead.
Deal structure protects the downside: $750,000 asking with $600,000 cash at close and a $150,000 seller note to a qualified physician buyer, plus a 6 to 12 month owner handover at market comp. There is no real estate to finance and no AR being purchased, keeping the capital outlay tight. At 1.27x SDE, the payback math is fast if a physician buyer simply restores utilization.

How to improve it

Expand clinical hours immediately: the office is staffed and equipped for a full schedule, so a full-time dermatologist can roughly double the current 22 weekly patient hours. This is the single largest lever, converting fixed overhead into incremental high-margin revenue within the first quarter. Target filling the four-day part-time calendar to a standard five-day full-time load.
Recover the 3 to 4 daily no-show slots the seller flags by tightening scheduling, adding confirmation texts, and running a same-day waitlist. At two surgical excisions a day plus procedures, each recovered slot carries meaningful revenue. This is a near-zero-cost operational fix executable in the first 90 days.
Restart marketing from a near-zero base: the seller states advertising is essentially nonexistent today. In a metro with four-month new-patient waits, even modest local digital and referral-physician outreach should fill the calendar quickly. Rebuild the referring-physician relationships the owner can introduce during the transition window.
Rebuild the cosmetic program, which was larger under the practice's earlier multi-provider model. Botox, fillers, Morpheus8, and PRP are time-of-service cash revenue with strong margins and no insurance friction. Adding an aesthetician in the available room extends capacity without requiring a second physician.
Add Mohs surgery with a qualified surgeon to capture higher-value skin cancer cases currently referred out. With about two excisions a day already and a Medicare surveillance base, in-house Mohs keeps revenue inside the practice. This also strengthens the referral moat against corporate mid-level competitors.
Hire a second provider to use the space built for two to three clinicians. The suite has four procedure-capable rooms and room for another provider, so a mid-level or associate physician scales revenue against the same rent and management overhead. This is the path to turning a $1.1M practice back into a multi-provider operation.
Evaluate adding Medicaid or expanding commercial payer contracts selectively to broaden the funnel in a high-growth, underserved metro. The practice currently excludes Medicaid, which caps new-patient flow. Weigh reimbursement rates against capacity to ensure added volume is accretive.

Diligence notes

Scrutinize the revenue decline over the past few years that the seller attributes to downsizing to a single part-time physician. Pull three to five years of payer-level revenue and visit counts to confirm the drop is purely capacity-driven and not patient attrition, lost referral relationships, or payer rate erosion. This distinction determines whether the growth thesis is real.
Verify the $592,712 SDE and the add-back schedule in the CIM, confirming the normalization to market rent and any owner-comp assumptions. Because the headline is a 52% margin, a buyer must confirm the physician's clinical compensation is appropriately treated, since a successor physician's pay is a real cost, not an add-back. Reconcile SDE to tax returns and P&Ls.
Confirm the compliance and clinical history the seller reports as clean: no litigation, liens, exclusions, or HIPAA breaches. Independently check OIG exclusion lists, state medical board records for the physician, and malpractice history. Review coding practices on the high excision and biopsy volume to ensure billing integrity before assuming the revenue base.
Pin down provider continuity and transferability since this is a physician-dependent practice. Confirm the referral network will follow a new physician, assess the risk of Medicare surveillance patients transferring, and validate that the practice manager and lead MA will actually stay post-close. The 6 to 12 month owner transition is central, so paper the handover terms clearly.
Review the lease on the 3,100 square foot suite, including remaining term, renewal options, and rent versus the market rent used in SDE normalization. Since no real estate conveys, lease security is critical to the going concern. Confirm the suite's suitability for scaling to two or three providers as the growth plan assumes.
Understand the asset sale structure and excluded AR: buyer takes no receivables, so model working capital needs from day one. Confirm the $150,000 seller note terms, the qualified-physician condition, and whether a non-physician PE or group buyer loses that financing. Clarify any non-compete from the retiring owner given the strength of his personal referral relationships.

Source

Originally listed on BizBuySell. View original listing →