Organization
DOCTOR K DERM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAUTILYA SHAURYA MD (PRESIDENT)
(321) 271-6522
Entity
Organization
Contact information
Practice address
2100 N WICKHAM RD, MELBOURNE, FL 32935-8110
(321) 752-7100
(321) 752-7105
Mailing address
2100 N WICKHAM RD, MELBOURNE, FL 32935-8110
(321) 752-7100
(321) 752-7105
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
05/15/2024
Last updated
06/20/2025
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