Organization
PROMENADES DERMATOLOGY, LLC
Active
Organization
PROMENADES DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERNICE BAROUDI DO (PHYSICIAN)
(941) 627-5155
Entity
Organization
Contact information
Practice address
3222 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8048
(941) 627-5155
Mailing address
3222 TAMIAMI TRL, PORT CHARLOTTE, FL 33952-8048
(941) 627-5155
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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