Organization
COUNTRYSIDE DERMATOLOGY AND LASER CENTER INC
Active
Organization
COUNTRYSIDE DERMATOLOGY AND LASER CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN S ROPER M.D. (OWNER)
(727) 791-1411
Entity
Organization
Contact information
Practice address
2467 ENTERPRISE RD, SUITE A, CLEARWATER, FL 33763-1724
(727) 791-1411
(727) 791-1419
Mailing address
2467 ENTERPRISE RD, SUITE A, CLEARWATER, FL 33763-1724
(727) 791-1411
(727) 791-1419
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
46341
FL
Other
Enumeration date
10/17/2007
Last updated
10/17/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up