# PRISIA DERMATOLOGY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Prisia Dermatology LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528792223
- **Authorized official:** MR. AUSTIN SHARP (OWNER)
- **Authorized official phone:** (727) 810-5524

## Contact information

- **Practice address:** 9300 CONROY WINDERMERE RD, WINDERMERE, FL 34786-5000
- **Practice address phone:** (844) 844-5005
- **Practice address fax:** (844) 444-1228
- **Mailing address:** PO BOX 216, WINDERMERE, FL 34786-0216

## Taxonomy

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

## Other

- **Enumeration date:** 07/11/2022
- **Last updated:** 09/13/2022