| NPI | 1902067671 |
|---|---|
| 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 |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2010-04-21 |