Organization

Acute Dermatology Clinic Pa

Clinic/Center in Fort Myers, FL(View on Map)

Legal Business Name

Acute Dermatology Clinic Pa

NPI Number

1427221605

NPI Type

Organization

Enumeration Date

04/08/2008

Specialties

(Taxonomies)

Code

261Q00000X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

OS9425

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 101295
9400 GLADIOLUS DR

City

Cape Coral
Fort Myers

State

FL
FL

Postal Code

33910-1295
33908-6699

Country

US
US

Telephone Number

(239) 482-7546
(239) 482-7546

Authorized Official

Name

Dr. Chau Vu

Title or Position

OWNER

Telephone Number

(239) 482-7546

Identifiers

Identifier

AJ932
274238100

Identifier State

FL
FL

Identifier Issuer

MEDICARE PTAN
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/27/2008

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