Provider Demographics
NPI:1225833874
Name:DERMATOLOGY GROUP OF FLORIDA PA
Entity type:Organization
Organization Name:DERMATOLOGY GROUP OF FLORIDA PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF RCM
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-237-7090
Mailing Address - Street 1:4000 HOLLYWOOD BLVD STE 215S
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-1227
Mailing Address - Country:US
Mailing Address - Phone:573-533-3386
Mailing Address - Fax:
Practice Address - Street 1:1361 13TH AVE S STE 180
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3235
Practice Address - Country:US
Practice Address - Phone:904-247-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty