Organization
SALIDA DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY QUEEN (AUTHORIZED OFFICIAL)
(561) 314-2000
Entity
Organization
Contact information
Practice address
234 N MAIN ST STE B, GUNNISON, CO 81230-2438
(970) 641-1456
Mailing address
4700 EXCHANGE CT STE 110, BOCA RATON, FL 33431-4450
(561) 314-2000
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
03/04/2024
Last updated
03/04/2024
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