Organization
PATIENT AND DERM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKHAIL VAYSBERG (OWNER)
(610) 529-0666
Entity
Organization
Contact information
Practice address
7250 RED BUG LAKE RD STE 1020, OVIEDO, FL 32765-9290
(407) 706-1770
(407) 706-1777
Mailing address
115 E CONCORD ST UNIT 1, ORLANDO, FL 32801-1337
(610) 529-0666
(321) 319-9714
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
—
—
Other
Enumeration date
12/05/2022
Last updated
12/05/2022
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