Doctor K Derm LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DOCTOR K DERM LLC

Practice address

2100 N Wickham Rd
Melbourne, FL 32935-8110

Phone

(321) 752-7100

Fax

(321) 752-7105

NPI assigned

May 15, 2024

Last updated

Jun 20, 2025By 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

Kautilya Shaurya, MD

Title

President

Phone

(321) 271-6522

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750377600000",
    "number": "1841049541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358110",
            "telephone_number": "321-752-7100",
            "fax_number": "321-752-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 N WICKHAM RD",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329358110",
            "telephone_number": "321-752-7100",
            "fax_number": "321-752-7105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR K DERM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-15",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A",
        "authorized_official_last_name": "SHAURYA",
        "authorized_official_first_name": "KAUTILYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-271-6522",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Melbourne, FL
• Providers in Melbourne, FL by specialty
• Dermatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.