Organization
FLORIDA DERMATOLOGY PLASTIC SURGERY LLC
Active
Organization
FLORIDA DERMATOLOGY PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANITA SALUJA M.D. (MANAGER)
(321) 917-3067
Entity
Organization
Contact information
Practice address
6559 N WICKHAM RD, SUITE 105, MELBOURNE, FL 32940-2039
(321) 345-0552
Mailing address
PO BOX 628721, ORLANDO, FL 32862-8721
(321) 241-1160
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M82777
FL
208200000X
Plastic Surgery Physician
ME118444
FL
Other
Enumeration date
11/29/2016
Last updated
06/02/2020
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