Unknown Individual – Dermatology Physician, NPI 1720095102
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
Mount Dora Post Office, 2600, CR Old 441, Mount Dora, Lake County, Florida, 32757, United States
MOUNT DORA, FL 327561783
Phone: (877) 277-7077
Fax: (734) 789-9152
Type: Mailing
27730, Riverwalk Way, Bonita Heights Mobile Home Park, Bonita Springs, Lee County, Florida, 34134, United States
BONITA SPRINGS, FL 341348691
Phone: (239) 498-2207
Fax: (239) 498-5006
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 32756)
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