Organization
SUMMIT DERMATOLOGY AND SPA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE LAING (MANAGER)
(850) 518-3881
Entity
Organization
Contact information
Practice address
3298 SUMMIT BLVD STE 12, PENSACOLA, FL 32503-4350
(850) 518-3881
Mailing address
3298 SUMMIT BLVD STE 12, PENSACOLA, FL 32503-4350
(850) 746-0650
(850) 746-0651
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018326600
—
FL
Enumeration date
04/15/2022
Last updated
12/23/2022
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