Organization
BLUEWATER DERMATOLOGY, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAYNE MARC FIELDER MD (OWNER)
(850) 585-1308
Entity
Organization
Contact information
Practice address
703 JUPITER ST, DESTIN, FL 32541-1810
(850) 585-1308
Mailing address
703 JUPITER ST, DESTIN, FL 32541-1810
(850) 585-1308
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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