ATLANTIC DERMATOLOGY LLC NPI 1306957378

NPI Information

  • NPI: 1306957378
  • Provider Name: ATLANTIC DERMATOLOGY LLC
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Organization
  • Address: 1980 N ATLANTIC AVE
    SUITE 722
    COCOA BEACH, FL
    ZIP 32931
  • Phone: (321) 784-8811

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NPI Details

ATLANTIC DERMATOLOGY LLC is a procedural dermatology dermatology in Cocoa Beach, FL. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). ATLANTIC DERMATOLOGY LLC NPI is 1306957378. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1980 N ATLANTIC AVE
SUITE 722
COCOA BEACH, FL
ZIP 32931-213
Phone: (321) 784-8811
Fax: (321) 799-4424

The provider's authorized official is Kristin Widick Smallwood .
The authorized official title is President and has the following contact phone number (321) 784-8811.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 9/11/2025.

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
1207N00000XDermatologyNo
2207NI0002XDermatologyClinical & Laboratory Dermatological ImmunologyNo
3207NP0225XDermatologyPediatric DermatologyNo
4207NS0135XDermatologyProcedural DermatologyYes

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: 11/21/2025

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