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General NPI Number Information
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NPI Number | 1033879416
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Entity Type | Organization
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Legal Business Name | NUPLO DERMATOLOGY LLC
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Dates
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Enumeration Date | 12/27/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 718 LAKEVIEW RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33756-3460
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Country | US
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Telephone | 727-447-1229
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Fax |
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Provider Business Mailing Address
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Address Line | 718 LAKEVIEW RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33756-3460
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. LAUREN METTERLE
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Credential | MD
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Telephone | 813-785-4861
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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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