Organization
ORLANDO SKIN INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY WATERMAN DO (OWNER)
(386) 742-0419
Entity
Organization
Contact information
Practice address
110 POND CT, STE 301, DEBARY, FL 32713
(386) 742-0419
(386) 742-4119
Mailing address
110 POND CT, STE 301, DEBARY, FL 32713
(386) 742-0419
(386) 742-4119
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
OS4781
FL
Other
Enumeration date
06/22/2015
Last updated
06/22/2015
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