NPIMap

Academic Alliance in Dermatology, Inc

Organization Active NPI Dermatology Physician · Tarpon Springs, FL

NPI 1245807767 · NPPES record last updated Apr 21, 2022

Key facts

NPI
1245807767
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Practice address
1005 E Boyer St
Tarpon Springs, FL 34689-5501
Phone
(727) 934-7638
Fax
(727) 944-4052
NPI assigned
Jun 4, 2021
Organization subpart
Yes
Parent organization (as reported)
ACADEMIC ALLIANCE IN DERMATOLOGY, INC

Authorized official

Name
Angela Ruth Peterman
Title
President/Owner
Phone
(410) 766-0111

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Advanced Town Country (22 organizations share this tax ID)
Part of
Advanced Town Country

Locations

1005 E Boyer St
Tarpon Springs, FL 34689
Phone (727) 934-7638

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207N00000X Yes
MOHS-Micrographic Surgery Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207ND0101X
Dermatopathology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207ND0900X
Pediatric Dermatology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207NP0225X
Procedural Dermatology Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP		 207NS0135X

Addresses

Primary practice location

1005 E Boyer St
Tarpon Springs, FL 34689-5501

Mailing address

5210 Webb Rd
Tampa, FL 33615-4518
Phone (813) 882-9986

Other names

  • Academic Alliance in Dermatology Doing business as

Other providers in Tarpon Springs, FL

All providers in Tarpon Springs, FL · Dermatology Physician in Florida

Sources for this page

Verify at the official NPI Registry.