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General NPI Number Information
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NPI Number | 1154127173
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY GROUP OF FLORIDA PA
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 5911 N HONORE AVE STE 210
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City | SARASOTA
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State | FL
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Zip | 34243-2657
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Country | US
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Telephone | 941-308-7546
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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 |
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Fax |
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Authorized Official
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Title or Position | VP OF RCM
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Name | NANCY SEGUIN
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Credential |
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Telephone | 954-237-7090
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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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