Dermatology Boutique Pa

NPI 1104225887 - Dermatology - 207N00000X

NPI Details
NPI 1104225887
Enumeration Date 08/18/2014
Last Updated 08/18/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name CYNTHIA ANN CYNTHIA
Position OWNER
Phone (855) 465-6621
Fax (888) 407-3376
Practice Location
110 N FEDERAL HWY
STE 302
HALLANDALE BEACH FL, 33009-4300, US
Phone (855) 465-6621
Fax (888) 407-3376
Business Location
110 N FEDERAL HWY
STE 302
HALLANDALE BEACH FL, 33009-4300, US
Phone (855) 465-6621
Fax (888) 407-3376
Toxanomy
Taxonomy Code 207N00000X
License State Florida
License Number ME74763
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According to our database, Dermatology Boutique Pa NPI is 1104225887, taxonomy code is 207N00000X and license number is ME74763, license state is located at Florida. Dermatology Boutique Pa physically located at 110 N Federal Hwy, Hallandale Beach FL, 33009-4300. NPI Number 1033115704 has the healthcare provider type.

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1104225887 NPI number is provided on an as is basis without warranty of any kind. 1104225887 is maintained by the National Plan & Provider Enumeration System. The contents of Dermatology Boutique Pa are for informational purposes only.