# PATIENT AND DERM LLC

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

## Provider details

- **NPI number:** 1538879267
- **Authorized official:** MIKHAIL VAYSBERG (OWNER)
- **Authorized official phone:** (610) 529-0666

## Contact information

- **Practice address:** 7250 RED BUG LAKE RD STE 1020, OVIEDO, FL 32765-9290
- **Practice address phone:** (407) 706-1770
- **Practice address fax:** (407) 706-1777
- **Mailing address:** 115 E CONCORD ST UNIT 1, ORLANDO, FL 32801-1337
- **Mailing address phone:** (610) 529-0666
- **Mailing address fax:** (321) 319-9714

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | NULL | Yes |
| 207YX0007X | Plastic Surgery within the Head & Neck (Otolaryngology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/05/2022
- **Last updated:** 12/05/2022