Organization
GULFSHORE DERMATOLOGY AT CORALWOOD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW LEOPOLD SMITH (VICE PRESIDENT)
(239) 437-0562
Entity
Organization
Contact information
Practice address
326 DEL PRADO BLVD N STE 301, CAPE CORAL, FL 33909-2288
(239) 458-1131
(239) 458-7789
Mailing address
326 DEL PRADO BLVD N STE 301, CAPE CORAL, FL 33909-2288
(239) 458-1131
(239) 458-7789
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME74107
FL
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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