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General NPI Number Information
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NPI Number | 1053749879
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY & CUTANEOUS SURGERY INSTITUTE (DCSI), PA
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Dates
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Enumeration Date | 10/15/2013
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 12788 FOREST HILL BLVD STE 1004
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City | WELLINGTON
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State | FL
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Zip | 33414-4703
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Country | US
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Telephone | 561-246-1791
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Fax | 614-696-4565
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Provider Business Mailing Address
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Address Line | 12788 FOREST HILL BLVD STE 1004
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City | WELLINGTON
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State | FL
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Zip | 33414-4703
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Country | US
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Telephone | 561-246-1791
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Fax | 561-469-6456
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Authorized Official
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Title or Position | OWNER
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Name | MOUNIR WASSEF
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Credential | D.O.
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Telephone | 561-246-1791
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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 | OS10492
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License Number State | FL
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