Organization
DERMATOLOGY ASSOCIATES OF BAY COUNTY, P.A.
Active
Organization
DERMATOLOGY ASSOCIATES OF BAY COUNTY, P.A.
Active
Parent organization
DERMATOLOGY ASSOCIATES OF BAY COUNTY. P.A.
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERMATOLOGY ASSOCIATES OF BAY COUNTY. P.A.
Authorized official
DR. ROBERT JOHN SIRAGUSA MD (PRESIDENT)
(850) 769-1668
Entity
Organization
Contact information
Practice address
3025 6TH ST, MARIANNA, FL 32446-1930
(850) 769-1668
(850) 785-2123
Mailing address
1900 HARRISON AVE, PANAMA CITY, FL 32405-4542
(850) 769-1668
(850) 785-2123
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000164600
—
FL
01
—
99500
BCBS OF FL
—
Enumeration date
06/14/2011
Last updated
06/16/2011
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