Organization
REJUVA DERMATOLOGY & VEIN CENTER, PLLC
Active
Other names
Dermatology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOLTA RASOULI MD (CO-PRESENDENT)
(941) 529-0070
Entity
Organization
Contact information
Practice address
395 COMMERCIAL CT STE C, VENICE, FL 34292-1651
(941) 529-0070
(941) 529-0539
Mailing address
2389 E VENICE AVE UNIT 510, VENICE, FL 34292-2465
(941) 529-0070
(941) 529-0539
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
—
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
03/17/2021
Last updated
09/02/2025
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