Bold City Dermatology Llc

LBN: Bold City Dermatology Llc
Bold City Dermatology Llc is an health care organization with primary practice located at 316 Paseo Reyes Dr , St Augustine FL 32095-8464. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery, Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is the primary health care specialty. Bold City Dermatology Llc can be contacted via phone (904) 544-5800, or through Al Dabagh, Bishr via phone (704) 230-1302.

Contact Information

Primary practice address
316 Paseo Reyes Dr St Augustine FL 32095-8464
Phone: (904) 544-5800
Fax: (904) 544-5800
Website:
Map and Directions
Authorized official contact:
Name: Al Dabagh, Bishr Doctor of Medicine (MD)
Phone: (704) 230-1302

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X
Allopathic & Osteopathic Physicians / Pediatric Dermatology 207NP0225X
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X

Profile Details

NPI number 1538761655
LBN Legal business name Bold City Dermatology Llc
DBA Doing business as
Authorized official Al Dabagh, Bishr Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Nov 13th, 2020
Last updated Jan 26th, 2021 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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