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General NPI Number Information
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NPI Number | 1457479271
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF NORTHWEST FLORIDA PA
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 4850 GRANDE DR
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City | PENSACOLA
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State | FL
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Zip | 32504-5940
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Country | US
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Telephone | 850-477-4447
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Fax | 850-477-2225
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Provider Business Mailing Address
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Address Line | 4850 GRANDE DR
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City | PENSACOLA
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State | FL
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Zip | 32504-5940
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Country | US
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Telephone | 850-477-4447
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Fax | 850-477-2225
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | DR. AMY POTE WATSON
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Credential | MD
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Telephone | 850-477-4447
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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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