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General NPI Number Information
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NPI Number | 1336792811
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Entity Type | Organization
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Legal Business Name | CLEAR SKIN DERMATOLOGY, P.A.
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 10/29/2019
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Provider Practice Location Address
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Address Line | 2454 N MCMULLEN BOOTH RD STE 424
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City | CLEARWATER
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State | FL
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Zip | 33759-1339
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Country | US
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Telephone | 727-248-0118
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Fax | 727-286-9555
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Provider Business Mailing Address
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Address Line | 2454 N MCMULLEN BOOTH RD STE 424
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City | CLEARWATER
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State | FL
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Zip | 33759-1339
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Country | US
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Telephone | 727-248-0118
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Fax | 727-286-9555
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | RACHEL EPSTEIN
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Credential | DO
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Telephone | 727-248-0118
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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 | 207NS0135X
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Taxonomy Name | Procedural Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #3
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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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