Organization
LONG DERMATOLOGY PA
Active
Other names
ASSOCIATED DERMATOLOGIST PA
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN C LONG JR. MD (OWNER)
(386) 672-3111
Entity
Organization
Contact information
Practice address
155 N NOVA RD, ORMOND BEACH, FL 32174-5138
(386) 672-3111
(386) 672-6532
Mailing address
155 N NOVA RD, ORMOND BEACH, FL 32174-5138
(386) 672-3111
(386) 672-6532
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
ME68137
FL
Other
Enumeration date
05/16/2007
Last updated
04/20/2008
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