Provider Demographics
NPI:1497806459
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:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHILLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-237-7090
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:954-998-0976
Mailing Address - Fax:
Practice Address - Street 1:7800 SW 57TH AVE STE 611
Practice Address - Street 2:
Practice Address - City:SOUTH MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-5528
Practice Address - Country:US
Practice Address - Phone:305-740-6181
Practice Address - Fax:305-740-6140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0076218207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL77520OtherBCBS
FL77520OtherBCBS