| NPI | 1811005341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL B COVERMAN President 407-788-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL ME34331) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: FL ME34331) |
| 207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: FL ME34331) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-09-11 |