Organization
PRECISION DERMATOLOGY AND SKIN SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE HUBBARD (MANAGER)
(904) 716-5102
Entity
Organization
Contact information
Practice address
1550 RIVERSIDE AVE, JACKSONVILLE, FL 32204-4161
(904) 613-3966
Mailing address
1550 RIVERSIDE AVE STE A, JACKSONVILLE, FL 32204-4162
(904) 923-6647
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME76595
FL
207ND0101X
MOHS-Micrographic Surgery Physician
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Other
Enumeration date
06/16/2014
Last updated
06/30/2021
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