Organization
HILLCREST DERMATOLOGY AND PLASTIC SURGERY P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENDRICK SPENCE M.D. (PRESIDENT)
(407) 999-2585
Entity
Organization
Contact information
Practice address
733 HIGHWAY 466, LADY LAKE, FL 32159-6340
(407) 999-2585
(407) 999-2628
Mailing address
130 HILLCREST ST, ORLANDO, FL 32801-1210
(407) 999-2585
(407) 999-2628
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
OS8467
FL
207ND0900X
Dermatopathology Physician
ME73625
FL
208200000X
Plastic Surgery Physician
Primary
ME379241
FL
Other
Enumeration date
12/19/2013
Last updated
12/19/2013
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