Healthcare Provider Details

I. General information

NPI: 1467158964
Provider Name (Legal Business Name): TOTAL VEIN AND SKIN LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 S FEDERAL HWY STE 8
DELRAY BEACH FL
33483-3320
US

IV. Provider business mailing address

10383 HAGEN RANCH RD STE 100
BOYNTON BEACH FL
33437-3782
US

V. Phone/Fax

Practice location:
  • Phone: 561-278-1362
  • Fax: 561-278-4383
Mailing address:
  • Phone: 561-739-5252
  • Fax: 561-739-5255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0101X
TaxonomyMOHS-Micrographic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA MATTHEW BERLIN
Title or Position: OWNER
Credential: MD
Phone: 561-739-5252