SOUTHSIDE DERMATOLOGY, P.A. is a specialist in Jacksonville, FL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHSIDE DERMATOLOGY, P.A. NPI is 1023276607. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
4727 SUNBEAM RD
SUITE 101
JACKSONVILLE, FL
ZIP 32257-107
Phone: (904) 880-0622
Fax: (904) 880-0623
The provider's authorized official is Mary Trinh Pentel .
The authorized official title is President and has the following contact phone number (904) 880-0622.
The CLIA number assigned to this NPI record is 10D2262657 - physician office with a certificate type of Certificate of Compliance.
The enumeration date for this NPI number is 5/29/2008 and was last updated on 7/2/2014.