NPIMap

Organization Active NPI

Florida Specialty Dermatology Care LLC

  • Dermatopathology Physician
  • Tampa, FL
National Provider Identifier
1881940898
Registry record updated Jul 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology PhysicianTaxonomy code 207ND0900X
Legal business name
FLORIDA SPECIALTY DERMATOLOGY CARE LLC
Practice address
400 N Tampa St
Suite: 1100
Tampa, FL 33602-4719
Phone
(813) 275-9100
Fax
(813) 275-9201
NPI assigned
Jul 27, 2012
Organization subpart
Yes
Parent organization
AMERICAN SPECIALTY DERMATOLOGY CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 27, 2012

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

Authorized official

Name
Debra M Shelby
Title
Chief Nursing Officer
Phone
(813) 275-9100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ND0900X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

400 N Tampa St
Suite: 1100
Tampa, FL 33602-4719

Mailing address

400 N Tampa St
Suite: 1100
Tampa, FL 33602-4719
Phone (813) 275-9100

National Provider Directory

National Provider Directory

Locations

400 N Tampa St
Ste 1100
Tampa, FL 33602
Phone (813) 275-9100

Practitioners & affiliated clinicians

Practitioners 7

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": "1343347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343347200000",
    "number": "1881940898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N TAMPA ST",
            "address_2": "SUITE: 1100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024719",
            "telephone_number": "813-275-9100",
            "fax_number": "813-275-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N TAMPA ST",
            "address_2": "SUITE: 1100",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336024719",
            "telephone_number": "813-275-9100",
            "fax_number": "813-275-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA SPECIALTY DERMATOLOGY CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMERICAN SPECIALTY DERMATOLOGY CARE LLC",
        "enumeration_date": "2012-07-27",
        "last_updated": "2012-07-27",
        "status": "A",
        "authorized_official_last_name": "SHELBY",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "813-275-9100"
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2012; 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.