# PALADIN DERMATOLOGY LLC

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

## Provider details

- **NPI number:** 1225417082
- **Authorized official:** JOE HERNANDEZ (MANAGING OFFICIAL)
- **Authorized official phone:** (804) 648-4802

## Contact information

- **Practice address:** 44 A& B MEDICAL PARK BLVD, PETERSBURG, VA 23805
- **Practice address phone:** (804) 648-4802
- **Mailing address:** 1801 LIBBIE AVE STE 204, RICHMOND, VA 23226-1836

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 0024164803 | VA | Yes |

## Other

- **Enumeration date:** 05/27/2015
- **Last updated:** 10/27/2015