Healthcare Provider Details

I. General information

NPI: 1922281005
Provider Name (Legal Business Name): SOUTH FLORIDA DERMATOLOGY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 09/13/2023
Certification Date: 09/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 CORAL WAY SUITE 207
CORAL GABLES FL
33134
US

IV. Provider business mailing address

401 CORAL WAY SUITE 207
CORAL GABLES FL
33134
US

V. Phone/Fax

Practice location:
  • Phone: 305-445-2941
  • Fax: 305-445-7231
Mailing address:
  • Phone: 305-445-2941
  • Fax: 305-445-7231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. VITOR F WEINMAN
Title or Position: OWNER
Credential: MD
Phone: 305-445-2941