Organization
NATIONAL DERMATOLOGY HEALTHCARE OF CONNECTICUT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH MAYWALT (BILLING SUPERVISOR)
(813) 880-7546
Entity
Organization
Contact information
Practice address
8002 GUNN HWY, TAMPA, FL 33626-1603
(813) 880-7546
Mailing address
8002 GUNN HWY, TAMPA, FL 33626-1603
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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