MEDICARE: BAY HARBOR DERMATOLOGY & COSMETIC CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1932359726
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAY HARBOR DERMATOLOGY & COSMETIC CENTER

Provider Business Mailing Address
First Line	:	1045 95TH ST STE 300
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2108
Country	:	US
Telephone Number	:	305-403-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 95TH ST STE 300
Second Line	:
City	:	BAY HARBOR ISLANDS
State	:	FL
Zip	:	33154-2108
Country	:	US
Telephone Number	:	305-403-6100
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	DR. IGOR CHAPLIK
Credential	:	D.O.
Telephone Number	:	305-403-6100

Provider Enumeration Date	:	09/29/2008
Last Update Date	:	09/29/2008

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Directions to “BAY HARBOR DERMATOLOGY & COSMETIC CENTER ” Practice Location

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