Organization
BROWARD DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME OBED D.O. (MEDICAL DIRECTOR)
(954) 990-6591
Entity
Organization
Contact information
Practice address
500 SE 15TH ST, SUITE #108, FORT LAUDERDALE, FL 33316-1952
(954) 990-6591
Mailing address
500 SE 15TH ST, SUITE #108, FORT LAUDERDALE, FL 33316-1952
(954) 990-6591
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
OS9463
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OS9463
MEDICAL LICENSE
FL
Enumeration date
07/06/2012
Last updated
01/29/2014
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