Organization Active NPI

Miami Dermatology and Surgery, LLC

  • Dermatology Physician
  • Miami, FL
National Provider Identifier
1902771546
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MIAMI DERMATOLOGY AND SURGERY, LLC
Practice address
3659 S Miami Ave Ste 4002
Miami, FL 33133-4231
Phone
(305) 456-1425
Fax
(305) 530-8968
NPI assigned
Oct 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Peter Bittar, MDNPI 1811489784
Title
Manager/Co-Founder
Phone
(812) 239-9233

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 PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3659 S Miami Ave Ste 4002
Miami, FL 33133-4231

Mailing address

3659 S Miami Ave Ste 4002
Miami, FL 33133-4231
Phone (305) 456-1425

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260108000580 FL Part B Supplier - Clinic/Group Practice 9032695200 Receives reassigned benefits from 2 practitioners
Practice locations: Key Largo, FL; Miami, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2333446Miami Dermatology and Surgery LLC3659 S Miami Avesuite 4002, Miami, FL 33133RegistrationNov 4, 2027

National Provider Directory

National Provider Directory

Locations

3659 S Miami Ave
Ste 4002
Miami, FL 33133
Phone (305) 393-8810

Practitioners & affiliated clinicians

Practitioners 2

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": "1759708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1902771546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE STE 4002",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334231",
            "telephone_number": "305-456-1425",
            "fax_number": "305-530-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3659 S MIAMI AVE STE 4002",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331334231",
            "telephone_number": "305-456-1425",
            "fax_number": "305-530-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIAMI DERMATOLOGY AND SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-06",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "BITTAR",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "MANAGER/CO-FOUNDER",
        "authorized_official_telephone_number": "812-239-9233",
        "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": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.