| NPI | 1801191101 |
|---|---|
| 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 |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2014-12-04 |