Organization
FLORIDA SPECIALTY DERMATOLOGY CARE LLC
Active
Parent organization
AMERICAN SPECIALTY DERMATOLOGY CARE LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
AMERICAN SPECIALTY DERMATOLOGY CARE LLC
Authorized official
DEBRA M SHELBY (CHIEF NURSING OFFICER)
(813) 275-9100
Entity
Organization
Contact information
Practice address
400 N TAMPA ST, SUITE: 1100, TAMPA, FL 33602-4719
(813) 275-9100
(813) 275-9201
Mailing address
400 N TAMPA ST, SUITE: 1100, TAMPA, FL 33602-4719
(813) 275-9100
(813) 275-9201
Taxonomy
Speciality
Code
Description
License number
State
207ND0900X
Dermatopathology Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/27/2012
Last updated
07/27/2012
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