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Adult And Pediatric Dermatology Practitioners P A
Specialist in Port St Lucie, Florida
NPI 1417620469

Adult And Pediatric Dermatology Practitioners P A is a Specialist based in Rockaway, FL. Adult And Pediatric Dermatology Practitioners P A practices in Port St Lucie, FL. The NPI Number for Adult And Pediatric Dermatology Practitioners P A is 1417620469 and holds a License No. (Florida).

The current practice location address for Adult And Pediatric Dermatology Practitioners P A is 8980 S Us Highway 1 Ste 103, Port St Lucie, FL and can be reached out via phone at 772-446-9100 and via fax at 772-446-9810.

Location: 8980 S Us Highway 1 Ste 103, Port St Lucie, FL, 07866-2057
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1417620469
Provider Name
Adult And Pediatric Dermatology Practitioners P A
Credential
Provider Entity Type
Organization
Address
8980 S Us Highway 1 Ste 103, Port St Lucie, FL, 07866-2057
Phone Number
772-446-9100
Fax Number
772-446-9810
Provider Enumeration Date
07/27/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
MA851 01 FL MEDICARE
institution
Provider Business Practice Location Address Details
Address
8980 S Us Highway 1 Ste 103
City
Port St Lucie
State
Florida
Zip
34952-3482
Phone Number
772-446-9100
Fax Number
772-446-9810
person
Provider Business Mailing Address Details
Address
8980 S Us Highway 1 Ste 103
City
Port St Lucie
State
Florida
Zip
34952-3482
Phone Number
772-446-9100
Fax Number
772-446-9810
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
()
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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