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General NPI Number Information
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NPI Number | 1508256660
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 01/29/2015
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Provider Practice Location Address
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Address Line | 609 INDIAN ROCKS RD
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City | BELLEAIR
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State | FL
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Zip | 33756-2056
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Country | US
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Telephone | 727-446-6217
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Fax | 727-442-4712
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Provider Business Mailing Address
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Address Line | 609 INDIAN ROCKS RD
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City | BELLEAIR
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State | FL
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Zip | 33756-2056
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Country | US
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Telephone | 727-446-6217
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Fax | 727-442-4712
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE PETER PAVLIDAKEY
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Credential | M.D.
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Telephone | 727-446-6217
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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 | ME39860
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License Number State | FL
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