Organization
PONTE VEDRA PLASTIC SURGERY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ROBIN SOLOMON (DIRECTOR)
(904) 273-6200
Entity
Organization
Contact information
Practice address
209 PONTE VEDRA PARK DR, PONTE VEDRA BEACH, FL 32082-6600
(904) 273-6200
(904) 280-8013
Mailing address
209 PONTE VEDRA PARK DRIVE, PONTE VEDRA BEACH, FL 32082
(904) 273-6200
(904) 280-8013
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CC8991
RAILROAD MEDICARE/PALMETTO GPA
FL
Enumeration date
03/14/2008
Last updated
04/25/2024
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