Intracoastal Dermatology, Pllc

LBN: Intracoastal Dermatology, Pllc
Intracoastal Dermatology, Pllc is an health care organization with primary practice located at 4776 Hodges Blvd Ste 105 , Jacksonville FL 32224-7218. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Intracoastal Dermatology, Pllc can be contacted via phone (904) 655-5310, or through Adkisson, Kendall via phone (904) 655-5310.

Contact Information

Primary practice address
4776 Hodges Blvd Ste 105 Jacksonville FL 32224-7218
Phone: (904) 655-5310
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Adkisson, Kendall Doctor of Medicine (MD)
Phone: (904) 655-5310

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X ME110325 Florida

Profile Details

NPI number 1194079988
LBN Legal business name Intracoastal Dermatology, Pllc
DBA Doing business as
Authorized official Adkisson, Kendall Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 1st, 2012
Last updated Jan 24th, 2022 - about 2 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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