Organization
ACADEMIC DERMATOLOGY CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL J BERNHARDT MD (PRESIDENT/OWNER)
(904) 387-4991
Entity
Organization
Contact information
Practice address
1514 NIRA ST, JACKSONVILLE, FL 32207-9702
(904) 387-4991
(904) 384-3613
Mailing address
1514 NIRA ST, JACKSONVILLE, FL 32207-9702
(904) 387-4991
(904) 384-3613
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
ME0042082
FL
Other
Enumeration date
09/22/2008
Last updated
12/15/2009
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