# B DERM PSC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194278689
- **Authorized official:** NICOLE M CANDELARIO MD (PRESIDENT)
- **Authorized official phone:** (787) 744-5353

## Contact information

- **Practice address:** PROFESSIONAL CENTER, \#2 LUIS MUNOZ RIVERA ST. SUITE 201, CAGUAS, PR 00725
- **Practice address phone:** (787) 744-5353
- **Practice address fax:** (787) 961-1189
- **Mailing address:** P.O. BOX 1176, CAGUAS, PR 00726
- **Mailing address phone:** (787) 744-5353
- **Mailing address fax:** (787) 961-1189

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 19349 | PR | Yes |

## Other

- **Enumeration date:** 08/01/2016
- **Last updated:** 03/28/2024