FORT MYERS DERMATOPATHOLOGY NPI 1083829337

NPI Information

  • NPI: 1083829337
  • Provider Name: FORT MYERS DERMATOPATHOLOGY
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • Address: 4901 PALM BEACH BLVD
    SUITE 12
    FORT MYERS, FL
    ZIP 33905
  • Phone: (239) 274-0005

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NPI Details

FORT MYERS DERMATOPATHOLOGY is a procedural dermatology dermatology in Fort Myers, FL. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). FORT MYERS DERMATOPATHOLOGY NPI is 1083829337. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4901 PALM BEACH BLVD
SUITE 12
FORT MYERS, FL
ZIP 33905-252
Phone: (239) 274-0005
Fax: (239) 278-4718

The provider's authorized official is Mazen Daoud .
The authorized official title is President and has the following contact phone number (239) 274-0005.

The enumeration date for this NPI number is 5/11/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207NS0135XDermatologyProcedural DermatologyYes

What is NPI?

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This page was last updated on: 3/30/2025

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