Healthcare Provider Details

I. General information

NPI: 1801448519
Provider Name (Legal Business Name): THE DERM GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 02/21/2023
Certification Date: 02/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 PONCE DE LEON BLVD
CORAL GABLES FL
33134-7251
US

IV. Provider business mailing address

11924 FOREST HILL BLVD STE 10A-411
WELLINGTON FL
33414-6256
US

V. Phone/Fax

Practice location:
  • Phone: 305-461-2000
  • Fax:
Mailing address:
  • Phone: 786-648-4431
  • Fax: 786-648-4432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: THEODORE GIUFFRIDA
Title or Position: PARTNER
Credential: MD
Phone: 305-502-3344