Provider Demographics
NPI:1578927596
Name:LOMBARDI INSTITUTE OF DERMATOLOGY
Entity Type:Organization
Organization Name:LOMBARDI INSTITUTE OF DERMATOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-848-5439
Mailing Address - Street 1:602 S AUDUBON AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-4217
Mailing Address - Country:US
Mailing Address - Phone:917-848-5439
Mailing Address - Fax:
Practice Address - Street 1:602 S AUDUBON AVE STE B
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-4217
Practice Address - Country:US
Practice Address - Phone:917-848-5439
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-06
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME116665207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty