Coral Reef Dermatology Llc

LBN: Coral Reef Dermatology Llc
Coral Reef Dermatology Llc is an health care organization with primary practice located at 160 Nw Central Park Plaza Suite 103, Port St Lucie FL 34986. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Coral Reef Dermatology Llc can be contacted via phone (772) 882-5612, or through Moore, Charlene via phone (772) 882-5612.

Contact Information

Primary practice address
160 Nw Central Park Plaza Suite 103 Port St Lucie FL 34986
Phone: (772) 882-5612
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Moore, Charlene Physician Assistant (PA)
Phone: (772) 882-5612

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1487300521
LBN Legal business name Coral Reef Dermatology Llc
DBA Doing business as
Authorized official Moore, Charlene Physician Assistant (PA)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 28th, 2022
Last updated Feb 28th, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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