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General NPI Number Information
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NPI Number | 1932324738
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Entity Type | Organization
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Legal Business Name | BAY POINTE DERMATOLOGY AND COSMETIC CENTER PA
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 08/04/2008
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Provider Practice Location Address
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Address Line | 3850 BIRD ROAD 104
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City | MIAMI
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State | FL
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Zip | 33146
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Country | US
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Telephone | 305-669-8337
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Fax | 305-856-4883
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Provider Business Mailing Address
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Address Line | 3850 BIRD ROAD 104
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City | MIAMI
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State | FL
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Zip | 33146
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Country | US
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Telephone | 305-669-8337
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Fax | 305-856-4883
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Authorized Official
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Title or Position | OWNER
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Name | JANICE LIMA-MARIBONA
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Credential | D.O.
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Telephone | 305-669-8337
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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 | OS0006885
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License Number State | FL
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