NPI 1306957378 · live from the CMS NPI Registry
Atlantic Dermatology LLC
Dermatology, Procedural Dermatology in Cocoa Beach, FL. National Provider Identifier 1306957378, active.
NPI record
| NPI | 1306957378 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Dermatology, Procedural Dermatology 207NS0135X |
| Practice location | 1980 N Atlantic Ave, Suite 722, Cocoa Beach, FL 32931 |
| Practice phone | 321-784-8811 |
| Enumerated | August 31, 2006 |
| Last updated | September 11, 2025 |
| Authorized official | Kristin Smallwood, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | — |
| Dermatology, Clinical & Laboratory Dermatological Immunology | 207NI0002X | — |
| Dermatology, Pediatric Dermatology | 207NP0225X | — |
| Dermatology, Procedural Dermatology primary | 207NS0135X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.