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Contact Information

PALADIN DERMATOLOGY LLC
44 A& B MEDICAL PARK BLVD
PETERSBURG, VA23805
 Phone: 804-648-4802
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for PALADIN DERMATOLOGY LLC

NPI # 1225417082
LBN Legal business name PALADIN DERMATOLOGY LLC
Authorized official JOE HERNANDEZ - (MANAGING OFFICIAL)
Entity Organization
Organization subpart 1 No
Enumeration date 05/27/2015
Last updated 10/27/2015 - About 11 years ago
Identifiers
VA License # 0024164803
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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