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ACADEMIC ALLIANCE IN DERMATOLOGY INC NPI 1386211217


NPI Information

NPI: 1386211217
Provider Name: ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 10D2205243

Address:
6901 SIMMONS LOOP STE 207
RIVERVIEW, FL
ZIP 33578
Phone: (813) 868-3052
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ACADEMIC ALLIANCE IN DERMATOLOGY, INC is a dermatology in Riverview, FL. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. ACADEMIC ALLIANCE IN DERMATOLOGY, INC NPI is 1386211217. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

6901 SIMMONS LOOP STE 207
RIVERVIEW, FL
ZIP 33578-498
Phone: (813) 868-3052
Fax: (813) 868-3046

The provider's authorized official is Angela Ruth Peterman .
The authorized official title is President/ceo and has the following contact phone number (410) 766-0111.

The CLIA number assigned to this NPI record is 10D2205243 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/9/2021 and was last updated on 4/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207ND0101XDermatologyMOHS-Micrographic SurgeryNo
2207ND0900XDermatologyDermatopathologyNo
3207NP0225XDermatologyPediatric DermatologyNo
4207NS0135XDermatologyProcedural DermatologyNo
5207N00000XDermatologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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