Intracoastal Dermatology, PLLC
Intracoastal Dermatology, PLLC provides Dermatology Physician services in Jacksonville, Florida. Licensed in Florida. Registered with an NPI since 2012.
- Licensed in
- FL
- In the registry since
- 2012
What do these letters mean?
- PLLC — Professional limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
4776 Hodges Blvd Ste 105Jacksonville, FL 32224-7218
Phone: (904) 655-5310
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Dermatology Physician (primary) | Taxonomy 207N00000X · Licence ME110325 (FL) |
|---|
Record details
| NPI number | 1194079988 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Kendall Adkisson — Manager · (904) 655-5310 |
| NPI enumerated | November 1, 2012 |
| Last updated in NPPES | January 24, 2022 |
| Certification date | January 24, 2022 |
| Mailing address | 4776 Hodges Blvd Ste 105, Jacksonville, FL 32224-7218 |
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