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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