Organization
BOCA GRANDE DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY J COREY M. D. (MANAGER)
(941) 855-9372
Entity
Organization
Contact information
Practice address
320 PARK AVENUE, BOCA GRANDE, FL 33921
(941) 964-0490
Mailing address
PO BOX 1883, 415 ROCK DOVE DR, BOCA GRANDE, FL 33921-1883
(941) 855-9372
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME116621
FL
Other
Enumeration date
02/17/2014
Last updated
12/09/2014
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