| 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 |