Boca Grande Dermatology Pllc

NPI 1063836773 - Dermatology - 207N00000X

NPI Details
NPI 1063836773
Enumeration Date 02/17/2014
Last Updated 12/09/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name TIMOTHY J TIMOTHY
Position MANAGER
Phone (941) 964-0490
Fax
Practice Location
320 PARK AVENUE
BOCA GRANDE FL, 33921, US
Phone (941) 964-0490
Fax
Business Location
PO BOX 1883
415 ROCK DOVE DR
BOCA GRANDE FL, 33921-1883, US
Phone (941) 855-9372
Fax
Toxanomy
Taxonomy Code 207N00000X
License State Florida
License Number ME116621
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According to our database, Boca Grande Dermatology Pllc NPI is 1063836773, taxonomy code is 207N00000X and license number is ME116621, license state is located at Florida. Boca Grande Dermatology Pllc physically located at 320 Park Avenue, Boca Grande FL, 33921. NPI Number 1033115704 has the healthcare provider type.

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1063836773 NPI number is provided on an as is basis without warranty of any kind. 1063836773 is maintained by the National Plan & Provider Enumeration System. The contents of Boca Grande Dermatology Pllc are for informational purposes only.