Provider Demographics
NPI:1699016220
Name:VMD DERMATOLOGY, LLC
Entity Type:Organization
Organization Name:VMD DERMATOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:J
Authorized Official - Last Name:LEON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-273-4641
Mailing Address - Street 1:3225 AVIATION AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-4741
Mailing Address - Country:US
Mailing Address - Phone:305-273-4641
Mailing Address - Fax:305-273-1497
Practice Address - Street 1:3225 AVIATION AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-4741
Practice Address - Country:US
Practice Address - Phone:305-273-4641
Practice Address - Fax:305-273-1497
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VITALMD GROUP HOLDING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty