Organization
SKIN DERMATOLOGY AND COSMETIC SERVICES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS CHARLES WHEELER M.D. (MEDICAL DIRECTOR)
(407) 599-7546
Entity
Organization
Contact information
Practice address
865 SAXON BLVD, ORANGE CITY, FL 32763-8204
(386) 256-1969
(407) 599-7506
Mailing address
865 SAXON BLVD, ORANGE CITY, FL 32763-8204
(386) 256-1969
(407) 599-7506
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME73845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2608936
—
FL
Enumeration date
04/25/2013
Last updated
03/22/2021
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