Organization
FAMILY DERMATOLOGY OF NORTH FLORIDA LLC
Active
Organization
FAMILY DERMATOLOGY OF NORTH FLORIDA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OEN-HIANG CYNTHIA TIE MD (AUTHORIZED OFFICIAL)
(850) 402-9444
Entity
Organization
Contact information
Practice address
1981 CAPITAL CIR NE, TALLAHASSEE, FL 32308-4421
(850) 402-9444
(850) 402-0188
Mailing address
1981 CAPITAL CIR NE, TALLAHASSEE, FL 32308-4421
(850) 402-9444
(850) 402-0188
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
257072600
—
FL
01
—
46953
BCBS
FL
Enumeration date
10/23/2019
Last updated
03/26/2024
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