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Organization

NATIONAL DERMATOLOGY HEALTHCARE OF LOUISIANA LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSH MAYWALT (BILLING MANAGER)
(813) 880-7546
Entity
Organization

Contact information

Practice address
8002 GUNN HWY, TAMPA, FL 33626-1603
(813) 880-7546
(813) 249-5210
Mailing address
8002 GUNN HWY, TAMPA, FL 33626-1603
(813) 880-7546
(813) 249-5210

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Enumeration date
05/07/2013
Last updated
05/07/2013
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