| NPI | 1073577136 |
|---|---|
| Doing Business As | PALM BAY DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | RUBEN MORENO President 321-768-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME51282) |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2023-11-10 |