Bliss Dermatology, LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

BLISS DERMATOLOGY, LLC

Doing business as

Bliss Dermatology

Practice address

315 Nokomis Ave S
Venice, FL 34285-2417

Phone

(941) 477-4007

Fax

(877) 239-7174

NPI assigned

Apr 20, 2023

Organization subpart

No

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

Authorized official

Name

Michelle Pennie, MDNPI 1497932784

Title

Owner

Phone

(941) 477-4007

Specialties & licenses 1

Addresses

Other names 1

• Bliss Dermatology Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 6

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

• Michelle Lundeen Pennie, MD

  • Dermatology Physician
  • Englewood, FL
  • NPI 1497932784
  Medicare reassignment Care Compare group NPD Authorized official
• Emily A Radtke, NP

  • Gerontology Nurse Practitioner
  • Orlando, FL
  • NPI 1467951160
  Medicare reassignment Care Compare group NPD
• Ashley E Gyeszat, APRN

  • Family Nurse Practitioner
  • Venice, FL
  • NPI 1548945371
  Medicare reassignment Care Compare group NPD (past)
• Catherine Lebeau, PA-C

  • Physician Assistant
  • Englewood, FL
  • NPI 1033973946
  Medicare reassignment Care Compare group
• Jennifer Vo, APRN

  • Medical Physician Assistant
  • Venice, FL
  • NPI 1134643281
  Medicare reassignment Care Compare group
• Samuel Vazquez-Milan, PA-C

  • Surgical Physician Assistant
  • Naples, FL
  • NPI 1255783114
  Medicare reassignment

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

{
    "created_epoch": "1681948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1689361644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 NOKOMIS AVE S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852417",
            "telephone_number": "941-477-4007",
            "fax_number": "877-239-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 NOKOMIS AVE S",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342852417",
            "telephone_number": "941-477-4007",
            "fax_number": "877-239-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLISS DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-20",
        "last_updated": "2025-09-02",
        "certification_date": "2025-06-26",
        "status": "A",
        "authorized_official_last_name": "PENNIE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-477-4007",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bliss Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dolores Theresa Biagini, PT
• Lauren Ashley Bigness
• Andrea Poist Bird, MSW,LCSW
• Melissa L Black, OD
• Darren J Blakeslee, ARNP
• Jeffrey R. Blood, MD
• Hannah Rylee Bloom, PA-C
• Jacy Bloom, D.C. M.S.
• Blue Horizon Anesthesia
• Blue Horizon Anesthesia

• MOHS-Micrographic Surgery Physician in Venice, FL
• Providers in Venice, 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 Sep 2, 2025; 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.