Provider Demographics
NPI:1750558516
Name:DERMATOLOGY SOLUTIONS A PROFESSION LIMITED LIABILITY COM
Entity type:Organization
Organization Name:DERMATOLOGY SOLUTIONS A PROFESSION LIMITED LIABILITY COM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FETT DESMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:239-694-7546
Mailing Address - Street 1:14071 METROPOLIS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4330
Mailing Address - Country:US
Mailing Address - Phone:239-694-7546
Mailing Address - Fax:239-694-1571
Practice Address - Street 1:14071 METROPOLIS AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4330
Practice Address - Country:US
Practice Address - Phone:239-694-7546
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-12
Last Update Date:2021-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME68928207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty