NPI | 1881984565 |
---|---|
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 |
Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
2086S0122X Surgery, Plastic and Reconstructive Surgery | |
Enumeration Date | 2011-04-14 |
Last Update Date | 2014-12-04 |