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ACADEMIC ALLIANCE IN DERMATOLOGY INC. NPI 1396312336


NPI Information

NPI: 1396312336
Provider Name: ACADEMIC ALLIANCE IN DERMATOLOGY, INC.
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 10D2056004

Address:
1201 S MYRTLE AVE
CLEARWATER, FL
ZIP 33756
Phone: (727) 442-1917
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ACADEMIC ALLIANCE IN DERMATOLOGY, INC. is a dermatology in Clearwater, 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 1396312336. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1201 S MYRTLE AVE
CLEARWATER, FL
ZIP 33756-424
Phone: (727) 442-1917
Fax: (727) 446-3490

The provider's authorized official is Panayiotis Vasiloudes .
The authorized official title is President, Ceo, Cmo and has the following contact phone number (813) 882-9986.

The CLIA number assigned to this NPI record is 10D2056004 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 6/8/2021 and was last updated on 6/8/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyYes
2207ND0101XDermatologyMOHS-Micrographic SurgeryNo
3207ND0900XDermatologyDermatopathologyNo
4207NS0135XDermatologyProcedural DermatologyNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1270808625MEDICAIDFLORIDA

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: 11/14/2023

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