Organization
MOBILEDERM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DECLUE (DIRECTOR, PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
3200 S UNIVERSITY DR, DAVIE, FL 33328-2018
(954) 970-5824
Mailing address
19230 NE 20TH CT, NORTH MIAMI BEACH, FL 33179-4369
(954) 970-5824
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
08/27/2008
Last updated
09/10/2008
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