Healthcare Provider Details

I. General information

NPI: 1598843914
Provider Name (Legal Business Name): SCHWEIGER DERMATOLOGY GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 12/13/2024
Certification Date: 12/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 E NORTH BLVD
LEESBURG FL
34748-5350
US

IV. Provider business mailing address

1132 E NORTH BLVD
LEESBURG FL
34748-5350
US

V. Phone/Fax

Practice location:
  • Phone: 352-365-6650
  • Fax: 352-365-0932
Mailing address:
  • Phone: 352-365-6650
  • Fax: 352-365-0932

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JORGE E TORRES
Title or Position: OWNER
Credential:
Phone: 352-365-6650