Organization
CREEKSIDE DERMATOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CASPER MD (PRESIDENT)
(352) 399-7295
Entity
Organization
Contact information
Practice address
8630 E COUNTY ROAD 466 STE A, THE VILLAGES, FL 32162-5614
(352) 399-7295
(352) 399-7294
Mailing address
8620 E COUNTY ROAD 466, THE VILLAGES, FL 32162-3670
(352) 399-7295
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
108772
FL
Other
Enumeration date
07/20/2017
Last updated
07/20/2017
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