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General NPI Number Information
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NPI Number | 1194424648
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Entity Type | Organization
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Legal Business Name | THE DERM GROUP LLP
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Dates
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Enumeration Date | 02/23/2023
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 333 NW 70TH AVE STE 116
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City | PLANTATION
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State | FL
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Zip | 33317-2364
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Country | US
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Telephone | 954-371-2208
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Fax | 954-405-8802
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Provider Business Mailing Address
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Address Line | 11924 FOREST HILL BLVD STE 10A-411
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City | WELLINGTON
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State | FL
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Zip | 33414-6256
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Country | US
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Telephone | 561-425-2929
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Fax | 561-810-1677
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Authorized Official
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Title or Position | PRESIDENT
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Name | THEODORE JOHN GIUFFRIDA
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Credential | MD
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Telephone | 305-461-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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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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