Organization
SKIN WELLNESS CENTER P A
Active
Organization
SKIN WELLNESS CENTER P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MELANIE R HAYNES M.D. (PRESIDENT DERMATOLOGIST)
(727) 545-3376
Entity
Organization
Contact information
Practice address
9005 BELCHER RD, PINELLAS PARK, FL 33782-4423
(727) 545-3376
(727) 545-5003
Mailing address
PO BOX 1548, PINELLAS PARK, FL 33780-1548
(727) 545-3376
(727) 545-5003
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME48813
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1081799
AETNA
FL
01
—
12272
BLUE CROSS BLUE SHIELD
FL
01
—
AS20877590001
CIGNA VENDOR NUMBER
FL
Enumeration date
08/25/2006
Last updated
01/10/2008
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