NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1801238472
INTEGRATED DERMATOLOGY OF TIDEWATER LLC
4700 EXCHANGE CT STE 110
BOCA RATON
FL
334314450
1689785578
SCHREIBER
JONATHAN
L
885 KEMPSVILLE RD
NORFOLK
VA
235023800
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