OrganizationActive
Charles Perniciaro MD PA
NPI 1407877392 · Dermatopathology Physician · Ponte Vedra Beach, FL
Provider details
- NPI number
- 1407877392
- Entity type
- Organization
- Primary specialty
- Dermatopathology PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Charles Perniciaro, Owner & Physician Provider
Practice location
183 Landrum Ln
Suite 201
Ponte Vedra Beach, FL 32082-3837
Phone: (904) 241-0633
Mailing address
Po Box 51498
Jacksonville Beach, FL 32240-1498
Registry dates
- Enumerated
- 2006-07-23
- Last updated
- 2014-12-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.