Organization
BEACHSIDE DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSALIND A FREAS MD (PHYSICIAN)
(321) 773-1266
Entity
Organization
Contact information
Practice address
2571 W EAU GALLIE BLVD, SUITE 2, MELBOURNE, FL 32935-8954
(321) 777-9091
Mailing address
2571 W EAU GALLIE BLVD, SUITE 2, MELBOURNE, FL 32935-8954
(321) 777-9091
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
03/06/2009
Last updated
06/02/2009
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