Organization Active NPI

Integrated Dermatology of Sunset Drive, LLC

  • Dermatology Physician
  • Miami, FL
National Provider Identifier
1689342602
Registry record updated Jul 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
INTEGRATED DERMATOLOGY OF SUNSET DRIVE, LLC
Practice address
7800 SW 87TH Ave Ste B200
Miami, FL 33173-3570
Phone
(305) 279-6012
Fax
(305) 279-7709
NPI assigned
Sep 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2026

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

Authorized official

Name
Anna Maria Miller
Title
Director of Credentialing
Phone
(561) 948-0291

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

7800 SW 87TH Ave Ste B200
Miami, FL 33173-3570

Mailing address

4700 Exchange CT Ste 110
Boca Raton, FL 33431-4450
Phone (561) 948-0291

Other practice location 1

15495 Eagle Nest Ln Ste 270
Miami Lakes, FL 33014-2267
Phone (305) 279-6012

Other names 1

  • Dermatology of Miami Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211018001459 FL Part B Supplier - Clinic/Group Practice 2264830512 Receives reassigned benefits from 4 practitioners
Practice locations: Miami, FL; Miami Lakes, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1107185Miami Dermatology and Laser Institute7800 SW 87TH Ave Ste B200, Miami, FL 33173ComplianceJul 14, 2026
10D2314249Integrated Dermatology of Sunset Drive LLC7800 SW 87TH Ave Suite B-200, Miami, FL 33173Provider-performed microscopyNov 14, 2026
10D2314325Integrated Dermatology of Sunset Drive LLC15495 Eagle Nest Lane Suite 270, Miami Lakes, FL 33014Provider-performed microscopyNov 17, 2026

National Provider Directory

National Provider Directory

Locations

15495 Eagle Nest Ln
Ste 270
Miami Lakes, FL 33014
Phone (305) 279-6012

6175 NW 153rd St
Ste 320
Miami Lakes, FL 33014
Phone (305) 364-0220

Networks

  • HealthSun Health Plans Network

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784505600000",
    "number": "1689342602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 EXCHANGE CT STE 110",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334314450",
            "telephone_number": "561-948-0291",
            "fax_number": "561-859-0429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7800 SW 87TH AVE STE B200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331733570",
            "telephone_number": "305-279-6012",
            "fax_number": "305-279-7709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15495 Eagle Nest Ln Ste 270",
            "address_purpose": "LOCATION",
            "city": "Miami Lakes",
            "state": "FL",
            "postal_code": "330142267",
            "country_code": "US",
            "telephone_number": "305-279-6012",
            "fax_number": "306-279-7709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED DERMATOLOGY OF SUNSET DRIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR OF CREDENTIALING",
        "authorized_official_telephone_number": "561-948-0291"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology of Miami",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.