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Organization

FLORIDA DERMATOLOGIC SURGERY & AESTHETICS INSTITUTE PA

Active
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Organization

FLORIDA DERMATOLOGIC SURGERY & AESTHETICS INSTITUTE PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ASHRAF M HASSANEIN MD (OWNER)
(352) 430-2580
Entity
Organization

Contact information

Practice address
11950 COUNTY ROAD 101, SUITE 203, THE VILLAGES, FL 32162-9332
(352) 430-2580
(352) 430-2651
Mailing address
11950 COUNTY ROAD 101, SUITE 203, THE VILLAGES, FL 32162-9332
(352) 430-2580
(352) 430-2651

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
68908
BCBS FL
FL
Enumeration date
03/12/2007
Last updated
08/27/2008
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