Organization
ADVANCED DERMATOLOGY OF PENNSYLVANIA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DECLUE (DIRECTOR OF PROVIDER SERVICES)
(407) 875-2080
Entity
Organization
Contact information
Practice address
525 JAMESTOWN ST, SUITE 206, PHILADELPHIA, PA 19128-1751
(215) 482-7546
Mailing address
151 SOUTHHALL LN, SUITE 300, MAITLAND, FL 32751-7176
(407) 875-2080
(407) 650-3455
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
12/05/2018
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