Emerald Coast Dermatology & Skin Surgery Center P A

NPI 1386639912 - Dermatology - 207N00000X

NPI Details
NPI 1386639912
Enumeration Date 09/20/2005
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name CHARLES F CHARLES
Position OWNER
Phone (850) 689-1740
Fax (850) 689-1740
Practice Location
350 REDSTONE AVE W
CRESTVIEW FL, 32536-6433, US
Phone (850) 689-1740
Fax (850) 689-1740
Business Location
350 REDSTONE AVE W
CRESTVIEW FL, 32536-6433, US
Phone (850) 689-1740
Fax (850) 682-6652
Toxanomy
Taxonomy Code 207N00000X
License State Florida
License Number ME89393
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According to our database, Emerald Coast Dermatology & Skin Surgery Center P A NPI is 1386639912, taxonomy code is 207N00000X and license number is ME89393, license state is located at Florida. Emerald Coast Dermatology & Skin Surgery Center P A physically located at 350 Redstone Ave W, Crestview FL, 32536-6433. NPI Number 1033115704 has the healthcare provider type.

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1386639912 NPI number is provided on an as is basis without warranty of any kind. 1386639912 is maintained by the National Plan & Provider Enumeration System. The contents of Emerald Coast Dermatology & Skin Surgery Center P A are for informational purposes only.