Graduated: 2001
NPI: 1164466314
Practice Locations (2)
PARK AVENUE DERMATOLOGY PA
1543 KINGSLEY AVE, SUITE 16
ORANGE PARK, FL 320734570
9045410315
PARK AVENUE DERMATOLOGY PA
906 PARK AVE
ORANGE PARK, FL 320734120
9045410315
Source: CMS National Downloadable File, September 2026.