| NPI | 1558339275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BROOKS Credentialing Manager 727-547-0607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: GA 049686) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery | |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2023-01-13 |