OrganizationActive
Divine Dermatology and Surgical Institute, PLLC
NPI 1215460290 · Medical Specialty Clinic/Center · Fort Collins, CO
Provider details
- NPI number
- 1215460290
- Entity type
- Organization
- Primary specialty
- Medical Specialty Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jennifer Divine, Owner(970) 388-2850
- License
- DR.0058205 (CO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1260 Doctors Ln
Fort Collins, CO 80524-4038
Phone: (813) 765-8453
Approximate (ZIP-level) locationGet directions
Mailing address
1260 Doctors Ln Ste a
Fort Collins, CO 80524-4072
Registry dates
- Enumerated
- 2017-04-06
- Last updated
- 2024-09-10
- Certified
- 2024-09-10
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.