Provider Demographics
NPI:1962002154
Name:PRECISION SKIN LLC
Entity Type:Organization
Organization Name:PRECISION SKIN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-998-0345
Mailing Address - Street 1:3501 S UNIVERSITY DR STE 5
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2001
Mailing Address - Country:US
Mailing Address - Phone:954-998-0345
Mailing Address - Fax:954-998-0344
Practice Address - Street 1:3501 S UNIVERSITY DR STE 5
Practice Address - Street 2:
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2001
Practice Address - Country:US
Practice Address - Phone:954-998-0345
Practice Address - Fax:954-998-0344
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty