Provider Demographics
NPI:1548739246
Name:ASSOCIATES & AFFILIATES IN DERMATOLOGY LLC
Entity Type:Organization
Organization Name:ASSOCIATES & AFFILIATES IN DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PANAYIOTIS
Authorized Official - Middle Name:
Authorized Official - Last Name:VASILOUDES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:813-341-1475
Mailing Address - Street 1:5210 WEBB RD STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4518
Mailing Address - Country:US
Mailing Address - Phone:813-341-1475
Mailing Address - Fax:813-885-5015
Practice Address - Street 1:5210 WEBB RD STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4518
Practice Address - Country:US
Practice Address - Phone:813-341-1475
Practice Address - Fax:813-885-5015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathologyGroup - Single Specialty