Organization
FLEMING ISLAND PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANNON DELP (DELEGATED OFFICIAL)
(904) 874-7215
Entity
Organization
Contact information
Practice address
1679 EAGLE HARBOR PKWY, SUITE C, FLEMING ISLAND, FL 32003-4815
(904) 348-0727
Mailing address
1679 EAGLE HARBOR PKWY, SUITE C, FLEMING ISLAND, FL 32003-4815
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
ME107749
FL
Other
Enumeration date
11/05/2015
Last updated
11/05/2015
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