Organization
WATER'S EDGE DERMATOLOGY, LLC
Active
Organization
WATER'S EDGE DERMATOLOGY, LLC
Active
Other names
Water's Edge Dermatology, INC
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN DAVIS (DIR. BILLING OPS)
(561) 693-0540
Entity
Organization
Contact information
Practice address
600 VILLAGE SQUARE CROSSING, PALM BEACH GARDENS, FL 33410
(561) 694-9493
(561) 694-9064
Mailing address
600 VILLAGE SQUARE CROSSING, PALM BEACH GARDENS, FL 33410
(561) 693-0540
(561) 296-6174
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38243
BCBS
FL
Enumeration date
07/19/2006
Last updated
12/11/2015
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