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BELLAVISTA DERMATOLOGY GROUP LLC NPI 1801379409


NPI Information

NPI: 1801379409
Provider Name: BELLAVISTA DERMATOLOGY GROUP LLC

Doing Business As: BELLAVISTA DERMATOLOGY

Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
3636 UNIVERSITY BLVD S
UNIT B2
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 297-1415
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BELLAVISTA DERMATOLOGY GROUP LLC is a dermatology in Jacksonville, FL. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. BELLAVISTA DERMATOLOGY GROUP LLC NPI is 1801379409. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Is Doing Business As Bellavista Dermatology.

The provider's business location address is:

3636 UNIVERSITY BLVD S
UNIT B2
JACKSONVILLE, FL
ZIP 32216
Phone: (904) 297-1415

The provider's authorized official is Rigel Martinez .
The authorized official title is Owner and has the following contact phone number (904) 297-1415.

The enumeration date for this NPI number is 9/10/2018 and was last updated on 9/10/2018.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0101XDermatologyMOHS-Micrographic SurgeryNo
2207ND0900XDermatologyDermatopathologyNo
3207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyNo
4207NP0225XDermatologyPediatric DermatologyNo
5207NS0135XDermatologyProcedural DermatologyNo
6207N00000XDermatologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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