Organization · Type 2 NPI
Fuller Dermatology LLC
Medical Specialty Clinic/Center · South Pasadena, FL
Practice location
1609 Pasadena Ave S Ste 4C
South Pasadena, FL 33707
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Specialty Clinic/Center Primary | 261QM2500X | ME99153 (FL) |
Medical Specialty Clinic/Center: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
About NPI 1083159529
Fuller Dermatology LLC's National Provider Identifier is 1083159529, issued on Dec 19, 2016. The primary taxonomy on file is Medical Specialty Clinic/Center (261QM2500X), and the practice location is in South Pasadena, FL. The record was last updated on Aug 29, 2018.