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Organization

CHARLES PERNICIARO MD PA

Active
Other names
Neptune Beach Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHARLES V. PERNICIARO M.D. (OWNER & PHYSICIAN PROVIDER)
(904) 241-0633
Entity
Organization

Contact information

Practice address
183 LANDRUM LN, SUITE 201, PONTE VEDRA BEACH, FL 32082-3837
(904) 241-0633
Mailing address
PO BOX 51498, JACKSONVILLE BEACH, FL 32240-1498
(904) 246-0908

Taxonomy

Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary

Other

Enumeration date
07/23/2006
Last updated
12/05/2014
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