| NPI | 1679574164 |
|---|---|
| Doing Business As | DERMATOLOGY AND LASER CENTER |
| Entity Type | Organization |
| Authorized Contact | N FRED EAGLSTEIN Physician/Owner 904-276-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2008-06-10 |