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Fuller Dermatology Llc
Medical Specialty Clinic/Center in South Pasadena, Florida
NPI 1083159529

Fuller Dermatology Llc is a Medical Specialty Clinic/Center based in South Pasadena, FL and is specialized in Medical Specialty. Fuller Dermatology Llc practices in South Pasadena, FL. The NPI Number for Fuller Dermatology Llc is 1083159529 and holds a License No. ME99153 (Florida).

The current practice location address for Fuller Dermatology Llc is 1609 Pasadena Ave S Ste 4C, South Pasadena, FL and can be reached out via phone at 727-347-7524.

Location: 1609 Pasadena Ave S Ste 4C, South Pasadena, FL, 33707-4564
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1083159529
Provider Name
Fuller Dermatology Llc
Credential
Provider Entity Type
Organization
Address
1609 Pasadena Ave S Ste 4C, South Pasadena, FL, 33707-4564
Phone Number
727-347-7524
Fax Number
Provider Enumeration Date
12/19/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1609 Pasadena Ave S Ste 4C
City
South Pasadena
State
Florida
Zip
33707
Phone Number
727-347-7524
Fax Number
person
Provider Business Mailing Address Details
Address
1609 Pasadena Ave S Ste 4C
City
South Pasadena
State
Florida
Zip
33707
Phone Number
727-347-7524
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
ME99153 (Florida)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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