NPI 1003063405

Mobilederm, INC.

Organisation Dermatology Physician Davie, FL

Practice location

Address: 3200 S University Dr, Davie, FL 33328-2018
Phone: (954) 970-5824
Mailing address: 19230 NE 20th CT, North Miami Beach, FL 33179-4369

Authorised official

Name: Amy Declue
Title: Director, Provider Services
Phone: (407) 875-2080

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

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Registry record

NPI: 1003063405
Entity type: Organization
NPI issued: 27 Aug 2008
Record last updated: 10 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.