Organization
WALL DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESTON WALL MD (PHYSICIAN OWNER)
(727) 432-3225
Entity
Organization
Contact information
Practice address
1700 66TH ST N STE 300, ST PETERSBURG, FL 33710-5500
(727) 432-3225
Mailing address
3000 BOCA CIEGA DR N, SAINT PETERSBURG, FL 33710-2834
(727) 432-3225
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Enumeration date
04/02/2024
Last updated
08/05/2024
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