NPI | 1851955983 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA LYNN PHILLIPS CEO 941-302-4669 |
Organization Subpart ? | No |
Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
Additional Taxonomies | 174400000X Specialist |
207N00000X Dermatology | |
207VG0400X Obstetrics & Gynecology, Gynecology | |
208200000X Plastic Surgery | |
208600000X Surgery | |
208D00000X General Practice | |
363A00000X Physician Assistant | |
363L00000X Nurse Practitioner | |
363LA2200X Nurse Practitioner, Adult Health | |
Enumeration Date | 2019-04-24 |
Last Update Date | 2025-01-27 |