Organization
VITAL DERMATOLOGY LLC
Active
Organization
VITAL DERMATOLOGY LLC
Active
Other names
Vital Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
JENNA BEASLEY MD (OWNER)
(850) 888-2424
Entity
Organization
Contact information
Practice address
6202 N 9TH AVE STE 2, PENSACOLA, FL 32504-8291
(850) 888-2424
(620) 710-7703
Mailing address
6202 N 9TH AVE STE 2, PENSACOLA, FL 32504-8291
(850) 888-2424
(620) 710-7703
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
11/12/2019
Last updated
05/03/2020
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