| NPI | 1093061582 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A SCANNON President 813-877-4811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2024-05-17 |