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Organization

WATERMAN DERMATOLOGY, PA

Active
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Organization

WATERMAN DERMATOLOGY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GARY L WATERMAN DO (DOCTOR)
(954) 473-2078
Entity
Organization

Contact information

Practice address
600 S PINE ISLAND RD, SUITE 102, PLANTATION, FL 33324-3166
(954) 473-2078
Mailing address
600 S PINE ISLAND RD, SUITE 102, PLANTATION, FL 33324-3166
(954) 473-2078

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OS4781
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982632527
TYPE I NPI NUMBER
FL
Enumeration date
01/19/2007
Last updated
08/22/2020
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