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General NPI Number Information
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NPI Number | 1407558562
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Entity Type | Organization
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Legal Business Name | LUX DERMATOLOGY HAIR & SKIN INSTITUTE LLC
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Dates
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Enumeration Date | 03/21/2023
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Last Update Date | 02/07/2026
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Provider Practice Location Address
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Address Line | 4004 S MACDILL AVE STE 2
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City | TAMPA
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State | FL
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Zip | 33611-1551
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Country | US
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Telephone | 813-669-5455
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Fax |
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Provider Business Mailing Address
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Address Line | 4004 S MACDILL AVE STE 2
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City | TAMPA
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State | FL
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Zip | 33611-1551
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Country | US
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Telephone | 813-665-5545
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Fax |
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Authorized Official
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Title or Position | CEO/DERMATOLOGIST
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Name | CHAUNCEY CALDWELL BARBULESCU
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Credential | MD
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Telephone | 507-202-5713
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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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