Provider Type Icon

PALM HARBOR DERMATOLOGY PA NPI 1497927016


NPI Information

NPI: 1497927016
Provider Name: PALM HARBOR DERMATOLOGY PA
Classification: Dermatology - 207ND0101X
Entity Type: Organization

Specialization: MOHS-Micrographic Surgery

CLIA Number: 10D1081226

Address:
4197 WOODLANDS PKWY
PALM HARBOR, FL
ZIP 34685
Phone: (727) 786-3810
Get Directions

PALM HARBOR DERMATOLOGY PA is a mohs-micrographic surgery dermatology in Palm Harbor, FL. The provider is the highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. PALM HARBOR DERMATOLOGY PA NPI is 1497927016. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4197 WOODLANDS PKWY
PALM HARBOR, FL
ZIP 34685-493
Phone: (727) 786-3810
Fax: (727) 786-3855

The provider's authorized official is Amy Simon Ross .
The authorized official title is Ceo and has the following contact phone number (813) 333-1512.

The CLIA number assigned to this NPI record is 10D1081226 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 3/25/2008 and was last updated on 7/27/2021.


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
1207N00000XDermatologyNo
2207ND0101XDermatologyMOHS-Micrographic SurgeryYes
3207ZD0900XPathologyDermatopathologyNo

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
1000WROTHERFLORIDAFLORIDA BLUE

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.