Provider Demographics
NPI:1598843914
Name:SCHWEIGER DERMATOLOGY GROUP PA
Entity type:Organization
Organization Name:SCHWEIGER DERMATOLOGY GROUP PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-365-6650
Mailing Address - Street 1:1132 E NORTH BLVD
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-5350
Mailing Address - Country:US
Mailing Address - Phone:352-365-6650
Mailing Address - Fax:352-365-0932
Practice Address - Street 1:1132 E NORTH BLVD
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-5350
Practice Address - Country:US
Practice Address - Phone:352-365-6650
Practice Address - Fax:352-365-0932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Multi-Specialty
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL40654Medicare ID - Type UnspecifiedGROUP NUMBER