Graduated: 2024
NPI: 1477382992
Practice Locations (2)
PARK AVENUE DERMATOLOGY PA
15255 MAX LEGGETT PKWY, SUITE 5000
JACKSONVILLE, FL 322187274
9045410315
PARK AVENUE DERMATOLOGY PA
906 PARK AVE
ORANGE PARK, FL 320734120
9045410315
Source: CMS National Downloadable File, September 2026.