Organization
SELECTSKINMD LLC
Active
Organization
SELECTSKINMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIKA SRIVASTAVA MD (OWNER)
(772) 567-1164
Entity
Organization
Contact information
Practice address
1325 36TH ST, SUITE A, VERO BEACH, FL 32960-6599
(772) 567-1164
Mailing address
1325 36TH ST, SUITE A, VERO BEACH, FL 32960-6599
(772) 567-1164
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME101443
FL
Other
Enumeration date
01/11/2016
Last updated
03/16/2016
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