Organization
CHARLES PERNICIARO MD PA
Active
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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