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General NPI Number Information
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NPI Number | 1780727941
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Entity Type | Organization
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Legal Business Name | AMERICAN MOBILE DERMATOLOGY
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1054 GATEWAY BLVD SUITE 110
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8309
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Country | US
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Telephone | 561-738-4770
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Fax | 561-738-9727
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Provider Business Mailing Address
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Address Line | 1054 GATEWAY BLVD SUITE 110
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8309
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Country | US
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Telephone | 561-738-4770
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Fax | 561-738-9727
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MISS SANDRA NOEMI DELGADO
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Credential |
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Telephone | 561-738-4770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | FL
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