NPIMap

Organization Active NPI

Blue Ocean Deramtology LLC

  • Dermatology Physician
  • Daytona Beach, FL
National Provider Identifier
1689551129
Registry record updated Aug 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
BLUE OCEAN DERAMTOLOGY LLC
Practice address
2672 Lpga Blvd
Daytona Beach, FL 32124-1008
Phone
(386) 256-1444
Fax
(321) 400-1118
NPI assigned
Aug 18, 2025
Last updated
Aug 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BLUE OCEAN DERAMTOLOGY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 18, 2025

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

Authorized official

Name
Nitra Hobbs WelchNPI 1821141714
Title
Owner
Phone
(386) 256-1444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

2672 Lpga Blvd
Daytona Beach, FL 32124-1008

Mailing address

3951 S Nova Rd
Port Orange, FL 32127-9270
Phone (386) 256-1444

National Provider Directory

National Provider Directory
Tax ID family
Blue Ocean Dermatology LLC6 organizations share this tax ID, including this one
Part of
Blue Ocean Dermatology LLC

Other organizations with this tax ID 5

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

Locations

2672 Lpga Blvd
Daytona Beach, FL 32124
Phone 3862561444 ext. 505

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1755475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1689551129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3951 S NOVA RD",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321279270",
            "telephone_number": "386-256-1444",
            "fax_number": "321-400-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2672 LPGA BLVD",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321241008",
            "telephone_number": "386-256-1444",
            "fax_number": "321-400-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE OCEAN DERAMTOLOGY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLUE OCEAN DERAMTOLOGY LLC",
        "enumeration_date": "2025-08-18",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "WELCH",
        "authorized_official_first_name": "NITRA",
        "authorized_official_middle_name": "HOBBS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-256-1444"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.