| NPI | 1366672610 |
|---|---|
| Doing Business As | ADVANCED DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | NEFRITA LOGAN Provider Service Rep 407-875-2080 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2009-07-21 |