Organization
PURE SKIN DERMATOLOGY AND AESTHETICS, LLC
Active
Organization
PURE SKIN DERMATOLOGY AND AESTHETICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEBRA L GRAYMAN M.D. (MGRM)
(407) 900-2580
Entity
Organization
Contact information
Practice address
7932 W SAND LAKE RD, SUITE 206, ORLANDO, FL 32819-7263
(407) 900-2580
Mailing address
7932 W SAND LAKE RD, SUITE 206, ORLANDO, FL 32819-7263
(407) 900-2580
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
ME98190
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598025447
GROUP NPI
FL
Enumeration date
05/25/2012
Last updated
02/14/2017
Update your record
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