Organization
MAGNIFYDX LLC
Active
Other names
DERMAGNIFY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK CAPPEL MD (OWNER)
(904) 686-7771
Entity
Organization
Contact information
Practice address
100 EXECUTIVE WAY STE 114, PONTE VEDRA BEACH, FL 32082-2713
(904) 842-3632
Mailing address
100 EXECUTIVE WAY STE 114, PONTE VEDRA BEACH, FL 32082-2713
(904) 842-3632
(877) 624-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
Other
Enumeration date
06/16/2021
Last updated
08/07/2024
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