| NPI | 1801379409 |
|---|---|
| Doing Business As | BELLAVISTA DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | RIGEL MARTINEZ Owner 904-297-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| 207ND0900X Dermatology, Dermatopathology | |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
| 207NP0225X Dermatology, Pediatric Dermatology | |
| 207NS0135X Dermatology, Procedural Dermatology | |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |