NPIMap

Academic Alliance in Dermatology, Inc

Organization Active NPI Dermatology Physician · Hudson, FL

NPI 1720655780 · NPPES record last updated Apr 22, 2022

Key facts

NPI
1720655780
Entity type
Organization (NPI type 2)
Primary specialty
Dermatology Physician 207N00000X
Legal business name
ACADEMIC ALLIANCE IN DERMATOLOGY, INC
Practice address
13910 Fivay Rd Ste 5
Hudson, FL 34667-7130
Phone
(727) 259-7930
Fax
(727) 935-0505
NPI assigned
Jun 8, 2021
Organization subpart
Yes
Parent organization (as reported)
ACADEMIC ALLIANCE IN DERMATOLOGY, INC

Authorized official

Name
Angela Ruth Peterman, MD
Title
President/Owner
Phone
(410) 776-0111

Corporate family (same tax ID) 21

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

Practitioners 11

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

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

13910 Fivay Rd Ste 5
Hudson, FL 34667-7130

Mailing address

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

Other providers in Hudson, FL

All providers in Hudson, FL · Dermatology Physician in Florida

Sources for this page

Verify at the official NPI Registry.