VISAGE DERMATOLOGY, LLC

ST PETERSBURG, FL
NPI1932200045
Entity TypeOrganization
Authorized ContactALEXANDRIA KONGSIRI
Physician
727-388-6982
Organization Subpart ?No
Primary Taxonomy174400000X Specialist
(Licence: FL  ME83035)
Enumeration Date2006-09-25
Last Update Date2008-07-17
Business Address
VISAGE DERMATOLOGY, LLC
5253 CENTRAL AVE
ST PETERSBURG, FL 33710-8141
Phone number: 727-388-6982
Mailing Address
VISAGE DERMATOLOGY, LLC
5253 CENTRAL AVE
ST PETERSBURG, FL 33710-8141
Phone number: 727-388-6982
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