| NPI | 1134148992 |
|---|---|
| Former Legal Business Name | WATER'S EDGE DERMATOLOGY, INC |
| Entity Type | Organization |
| Authorized Contact | SUSAN DAVIS Dir. Billing Ops 561-693-0540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2015-12-11 |