Dermatology Healthcare, LLC
Organization Active NPI Dermatology Physician · Tampa, FL
NPI 1124463104 · NPPES record last updated Mar 25, 2024
Key facts
- NPI
- 1124463104
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dermatology Physician 207N00000X
- Legal business name
- DERMATOLOGY HEALTHCARE, LLC
- Practice address
- 10820 Sheldon Rd
Tampa, FL 33626-5117 - Phone
- (813) 886-7673
- Fax
- (813) 792-7895
- NPI assigned
- May 6, 2013
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Norman, DO
- Title
- Ceo
- Phone
- (813) 886-7673
Practitioners 11
-
Jacqueline Del Val, APRN
-
Mark Matteson Fogg, DCNP, FNP, APRN
-
Shannon Jane O'Brien, F.N.P.
-
Holly Frances Pohler, ARNP
-
Sandra L Smith, APRN, FNP-BC
-
Janelle Wolek Marino, NP-C
-
Frances Ruth Vitalis, ARNP-C
-
Thierry R Chapuis, PA-C
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130618000025 | FL | Part B Supplier - Clinic/Group Practice | 3072752351 |
Receives reassigned benefits from 11 practitioners Practice locations: Tampa, FL |
National Provider Directory
Locations
10820 Sheldon Rd
Tampa, FL 33626
Phone (813) 886-7673
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician |
207N00000X | Yes |
Addresses
Primary practice location
10820 Sheldon Rd
Tampa, FL 33626-5117
Mailing address
10820 Sheldon Rd
Tampa, FL 33626-5117
Phone (813) 886-7673
Other providers in Tampa, FL
- Derick Dermatology, PLLC
- Derma Direct PLLC
- Dermatologist LLC
- Dermatology Associates of Tampa Bay, LLC
- Dermatology Group of Florida PA
- Dermatology Network of Florida, LLC
- Megan Dermer
- Charlotte Derr
- Derry H Cancio DDS PA
- Laurie J Deruosi
All providers in Tampa, FL · Dermatology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.