Organization
GULFSHORE DERMATOLOGY AT CORALWOOD, PA
Active
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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