Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207NS0135X | Procedural Dermatology | 21557 | FL |
NPI | 1023081692 |
---|---|
Provider Name | Dr. Phyllis Skolnik |
First Address | Miami, FL 33176-2208 |
Second Address | Miami, FL 33176-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 14/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
049850500 | (05) | FL |
D60169 | (02) | FL |