Organization
FORT MYERS DERMATOPATHOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZEN DAOUD MD (PRESIDENT)
(239) 274-0005
Entity
Organization
Contact information
Practice address
4901 PALM BEACH BLVD, SUITE 12, FORT MYERS, FL 33905-3252
(239) 274-0005
(239) 278-4718
Mailing address
8381 RIVERWALK PARK BLVD, SUITE 202, FORT MYERS, FL 33919-8760
(239) 274-0005
(239) 278-4718
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
—
—
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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