Organization
AESTHETIC DERMATOLOGY PA
Active
Organization
AESTHETIC DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID L ALLYN MD (MEDICAL DIRECTOR)
(352) 243-2544
Entity
Organization
Contact information
Practice address
210 N HIGHWAY 27 STE 1, CLERMONT, FL 34711-2411
(352) 243-2544
(352) 243-2745
Mailing address
210 NORTH HIGHWAY 27, SUITE 1, CLERMONT, FL 34711
(352) 243-2544
(352) 243-2745
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
ME70658
FL
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011965400
—
FL
05
—
011965403
—
FL
05
—
116894500
—
FL
Enumeration date
11/16/2006
Last updated
01/14/2025
Update your record
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