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General NPI Number Information
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NPI Number | 1033854104
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY GROUP OF FLORIDA, P.A.
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 154 S COMPASS WAY
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City | DANIA
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State | FL
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Zip | 33004-2368
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Country | US
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Telephone | 954-807-9433
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Fax |
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Provider Business Mailing Address
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Address Line | 4000 HOLLYWOOD BLVD STE 215S
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City | HOLLYWOOD
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State | FL
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Zip | 33021-1227
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Country | US
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Telephone | 29-672-6312
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Fax |
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Authorized Official
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Title or Position | VP RCM
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Name | NANCY SEGUIN
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Credential |
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Telephone | 954-433-0455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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