Organization
GALT DERMATOLOGY & CONCIERGE MEDICINE PA
Active
Other names
Galt Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MIGUEL VILLACORTA DO (PRESIDENT)
(954) 463-5406
Entity
Organization
Contact information
Practice address
800 E BROWARD BLVD, SUITE 103, FORT LAUDERDALE, FL 33301-2008
(954) 463-5406
(954) 522-2456
Mailing address
800 E BROWARD BLVD, SUITE 103, FORT LAUDERDALE, FL 33301-2008
(954) 463-5406
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
ME36538
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811442668
NPI
FL
Enumeration date
08/25/2011
Last updated
02/28/2025
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