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Organization

N FRED EAGLSTEIN DO PA

Active
Other names
Dermatology and Laser Center
Organization subpart
No

Provider details

NPI number
Authorized official
N FRED EAGLSTEIN DO (PHYSICIAN/OWNER)
(904) 276-4500
Entity
Organization

Contact information

Practice address
2055 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4461
(904) 276-4500
(904) 276-4160
Mailing address
2055 PROFESSIONAL CENTER DR, ORANGE PARK, FL 32073-4461
(904) 276-4500
(904) 276-4160

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043624100
FL
Enumeration date
08/09/2005
Last updated
06/10/2008
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