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General NPI Number Information
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NPI Number | 1689038549
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Entity Type | Individual
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Provider Name | VASSILIKI PAPASTAVROS
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Gender | Female
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 9050 PINES BLVD STE 200
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-6456
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Country | US
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Telephone | 954-433-0455
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Fax | 954-433-8771
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Provider Business Mailing Address
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Address Line | 2370 SW 131ST TER
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City | DAVIE
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State | FL
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Zip | 33325-5136
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Country | US
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Telephone | 954-632-7854
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | ME148876
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License Number State | FL
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