Organization
BRANDON DERMATOLOGY P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRES TOBON D.O. (PRESIDENTPHYSICIAN)
(813) 662-3376
Entity
Organization
Contact information
Practice address
405 W BLOOMINGDALE AVE, BRANDON, FL 33511-7401
(813) 662-3376
(813) 662-3009
Mailing address
405 W BLOOMINGDALE AVE, BRANDON, FL 33511-7401
(813) 662-3376
(813) 662-3009
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
OS7868
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AL785
MEDICARE PTAN
FL
Enumeration date
04/03/2007
Last updated
09/19/2008
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