Dermatologist LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

DERMATOLOGIST LLC

Practice address

9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550

Phone

(440) 804-5996

Fax

(216) 758-4783

NPI assigned

Mar 25, 2022

Last updated

Jun 4, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Olga Demidova, DONPI 1174915987

Title

Director

Phone

(216) 280-1343

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Olga Demidova, DO

  • MOHS-Micrographic Surgery Physician
  • Tampa, FL
  • NPI 1174915987
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1780531200000",
    "number": "1336899061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9724 N ARMENIA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127550",
            "telephone_number": "440-804-5996",
            "fax_number": "216-758-4783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9724 N ARMENIA AVE STE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336127550",
            "telephone_number": "440-804-5996",
            "fax_number": "216-758-4783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-25",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A",
        "authorized_official_last_name": "DEMIDOVA",
        "authorized_official_first_name": "OLGA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "216-280-1343",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Derby, DPM
• Allison Corinne Derespino, M.D.
• Derick Dermatology, PLLC
• Derick Dermatology, PLLC
• Derma Direct PLLC
• Dermatology Associates of Tampa Bay, LLC
• Dermatology Group of Florida PA
• Dermatology Healthcare, LLC
• Dermatology Network of Florida, LLC
• Megan Dermer

• MOHS-Micrographic Surgery Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.