Healthcare Provider Details

I. General information

NPI: 1295934602
Provider Name (Legal Business Name): NURSING HOME DERMATOLOGY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 02/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7280 W PALMETTO PARK RD STE 207N
BOCA RATON FL
33433-3401
US

IV. Provider business mailing address

7280 W PALMETTO PARK RD STE 207N
BOCA RATON FL
33433-3401
US

V. Phone/Fax

Practice location:
  • Phone: 561-314-0658
  • Fax: 561-368-3016
Mailing address:
  • Phone: 561-314-0658
  • Fax: 561-368-3016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberARNP2828762
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP2828762
License Number StateFL

VIII. Authorized Official

Name: PHILIP BRITTON
Title or Position: PRESIDENT
Credential:
Phone: 561-314-0658