MEDICARE: THE DERM GROUP LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician

General Provider Information

NPI Number	:	1538868104
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE DERM GROUP LLP

Provider Business Mailing Address
First Line	:	11924 FOREST HILL BLVD STE 10A-411
Second Line	:
City	:	WELLINGTON
State	:	FL
Zip	:	33414-6256
Country	:	US
Telephone Number	:	786-648-4431
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 W FLAGLER ST STE 105
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33174-2428
Country	:	US
Telephone Number	:	305-380-9916
Fax Number	:	305-428-8484

Authorized Official
Title or Position	:	PRESIDENT
Name	:	THEODORE JOHN GIUFFRIDA
Credential	:	MD
Telephone Number	:	305-461-2000

Provider Enumeration Date	:	03/02/2023
Last Update Date	:	03/02/2023

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Directions to “THE DERM GROUP LLP ” Practice Location

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