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General NPI Number Information
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NPI Number | 1497937791
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Entity Type | Organization
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Legal Business Name | SOUTHERNMOST DERMATOLOGY LLC
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Dates
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Enumeration Date | 11/29/2007
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Last Update Date | 02/07/2008
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Provider Practice Location Address
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Address Line | 1411 WHITE ST
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City | KEY WEST
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State | FL
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Zip | 33040-4813
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Country | US
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Telephone | 305-294-5400
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Fax | 305-294-5415
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Provider Business Mailing Address
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Address Line | 1411 WHITE ST
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City | KEY WEST
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State | FL
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Zip | 33040-4813
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Country | US
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Telephone | 305-294-5400
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Fax | 305-294-5415
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Authorized Official
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Title or Position | OWNER DOCTOR
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Name | DR. MICHAEL EVANS BERMAN
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Credential | MD
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Telephone | 305-294-5400
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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 | ME48734
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License Number State | FL
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