PALM HARBOR DERMATOLOGY PA NPI 1497927016

NPI Information

  • NPI: 1497927016
  • Provider Name: PALM HARBOR DERMATOLOGY PA
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 10D1081226
  • Address: 4197 WOODLANDS PKWY
    PALM HARBOR, FL
    ZIP 34685
  • Phone: (727) 786-3810

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NPI Details

PALM HARBOR DERMATOLOGY PA is a dermatology in Palm Harbor, 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. PALM HARBOR DERMATOLOGY PA NPI is 1497927016. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

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 2/28/2025.

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
1207N00000XDermatologyYes
2207ND0101XDermatologyMOHS-Micrographic SurgeryNo
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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