Provider Demographics
NPI:1710695408
Name:DNP-DERM LLC
Entity Type:Organization
Organization Name:DNP-DERM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEISCHA
Authorized Official - Middle Name:N
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:315-882-2967
Mailing Address - Street 1:2501 WALDEN WOODS DR # 4087
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-9998
Mailing Address - Country:US
Mailing Address - Phone:813-330-0106
Mailing Address - Fax:833-464-3525
Practice Address - Street 1:2501 WALDEN WOODS DR # 4087
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-7168
Practice Address - Country:US
Practice Address - Phone:813-330-0106
Practice Address - Fax:833-464-3525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty