NPI: 1851955983 · BRADENTON, FL 34209 · Specialist · NPI assigned 04/24/2019
| Authorized Official | PHILLIPS, JESSICA (CEO) |
| NPI Enumeration Date | 04/24/2019 |
Other providers sharing the same authorized official: PHILLIPS, JESSICA
| Provider | City | State | Total Paid |
|---|---|---|---|
| LUMINARY DERMATOLOGY OF OKLAHOMA, LLC | EDMOND | OK | $19K |
| Year | Claims | Total Paid |
|---|---|---|
| 2022 | 17 | $318.20 |
| Code | Description | Claims | Beneficiaries | Total Paid |
|---|---|---|---|---|
| 99213 | Office or other outpatient visit for the evaluation and management of an established patient, low complexity | 17 | 15 | $318.20 |