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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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