Organization
ATLANTIC SKIN SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD A JAMES M.D. (CHIEF OPERATING OFFICER)
(772) 828-1907
Entity
Organization
Contact information
Practice address
176 NW MAGNOLIA LAKES BLVD, PORT ST LUCIE, FL 34986-3567
(772) 828-1907
Mailing address
176 NW MAGNOLIA LAKES BLVD, PORT ST LUCIE, FL 34986-3567
(772) 828-1907
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
ME66880
FL
Other
Enumeration date
07/23/2012
Last updated
07/23/2012
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