Provider Demographics
NPI:1033854104
Name:DERMATOLOGY GROUP OF FLORIDA, P.A.
Entity Type:Organization
Organization Name:DERMATOLOGY GROUP OF FLORIDA, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP RCM
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-433-0455
Mailing Address - Street 1:4000 HOLLYWOOD BLVD STE 215S
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1227
Mailing Address - Country:US
Mailing Address - Phone:029-672-6312
Mailing Address - Fax:
Practice Address - Street 1:154 S COMPASS WAY
Practice Address - Street 2:
Practice Address - City:DANIA
Practice Address - State:FL
Practice Address - Zip Code:33004-2368
Practice Address - Country:US
Practice Address - Phone:954-807-9433
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty