Organization
WATERSIDE DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERFON EKHLASSI MD (OWNER AND PHYSICIAN)
(941) 748-3376
Entity
Organization
Contact information
Practice address
300 RIVERSIDE DR E STE 2200, BRADENTON, FL 34208-1023
(941) 748-3376
(941) 748-7562
Mailing address
300 RIVERSIDE DR E STE 2200, BRADENTON, FL 34208-1023
(941) 748-3376
(941) 748-7562
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
Other
Enumeration date
07/05/2023
Last updated
03/05/2025
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