Provider Demographics
NPI:1417640046
Name:PRECISION HEALTHCARE SPECIALISTS
Entity Type:Organization
Organization Name:PRECISION HEALTHCARE SPECIALISTS
Other - Org Name:PRECISION DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIR OF ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MARONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:941-626-1530
Mailing Address - Street 1:6321 DANIELS PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4773
Mailing Address - Country:US
Mailing Address - Phone:941-626-1530
Mailing Address - Fax:
Practice Address - Street 1:13691 METRO PKWY STE 200
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4321
Practice Address - Country:US
Practice Address - Phone:239-291-3604
Practice Address - Fax:239-291-3605
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRECISION HEALTHCARE SPECIALISTS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-30
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty