Organization
NORTH FLORIDA DERMATOLOGY LLC
Active
Organization
NORTH FLORIDA DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY TEPEDINO MD (OWNER)
(386) 344-6102
Entity
Organization
Contact information
Practice address
1722 SW NEWLAND WAY, LAKE CITY, FL 32025-6915
(386) 344-6102
(386) 344-6103
Mailing address
PO BOX 530033, ATLANTA, GA 30353-0033
(386) 344-6102
(386) 344-6103
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME122956
FL
Other
Enumeration date
06/08/2016
Last updated
03/07/2024
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