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General NPI Number Information
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NPI Number | 1851400949
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY ASSOCIATES OF NAPLES LLC
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9510 BONITA BEACH RD SE UNIT 101
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City | BONITA SPRINGS
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State | FL
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Zip | 34135-4699
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Country | US
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Telephone | 239-597-1400
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Fax | 239-597-4144
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Provider Business Mailing Address
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Address Line | 100 WHITE SPRUCE BLVD
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City | ROCHESTER
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State | NY
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Zip | 14623-1507
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Country | US
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Telephone | 585-272-0700
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Fax | 585-697-0822
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT W. LOSS JR.
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Credential | M.D.
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Telephone | 585-272-0700
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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 | 0610123
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License Number State | FL
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