Organization
COMPREHENSIVE DERMATOLOGY AND DERMATOLOGIC SURGERY, PLC
Active
Other names
Comprehensive Dermatology and Facial Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YVETTE MEJIA (BILLING SUPERVISOR)
(407) 339-7546
Entity
Organization
Contact information
Practice address
201 N LAKEMONT AVE, SUITE 100, WINTER PARK, FL 32792-3228
(407) 339-7546
Mailing address
201 N LAKEMONT AVE, SUITE 100, WINTER PARK, FL 32792-3228
(407) 339-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME105564
FL
207ND0101X
MOHS-Micrographic Surgery Physician
ME105564
FL
207NS0135X
Procedural Dermatology Physician
ME105564
FL
207YS0123X
Facial Plastic Surgery Physician
ME105587
FL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
ME105587
FL
2082S0099X
Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
ME105587
FL
Other
Enumeration date
06/25/2013
Last updated
06/25/2013
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