NPI | 1316105810 |
---|---|
Doing Business As | ADVANCED DERMATOLOGY AND COSMETIC SURGERY |
Entity Type | Organization |
Authorized Contact | AMY DECLUE Director, Provider Services 407-875-2080 |
Organization Subpart ? | Yes |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
208200000X Plastic Surgery | |
Enumeration Date | 2008-05-30 |
Last Update Date | 2013-11-12 |