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General NPI Number Information
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NPI Number | 1538270335
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Entity Type | Organization
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Legal Business Name | AQUA DERMATOLOGY OF FLORIDA, PA
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 900 VILLAGE SQUARE XING STE 210
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-4550
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Country | US
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Telephone | 239-313-2515
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 748497
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City | ATLANTA
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State | GA
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Zip | 30374-8497
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Country | US
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Telephone | 239-313-2515
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | THEODORE SCHIFF
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Credential | M.D.
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Telephone | 239-313-2515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State | FL
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