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NPI 1659948503 · live from the CMS NPI Registry

Academic Alliance In Dermatology, PLLC

Dermatology in Tampa, FL. National Provider Identifier 1659948503, active.

NPI record

NPI1659948503 Type 2 · organization
StatusActive
Primary specialtyDermatology 207N00000X
Practice location6331 Memorial Hwy, Tampa, FL 33615
Practice phone813-682-1031
Mailing addressPo Box 23329, New York, NY 10087
EnumeratedJune 9, 2021
Last updatedSeptember 14, 2026
Authorized officialNicole Proffitt, Director Of Enrollment & Credential

Taxonomies and licenses

TaxonomyCodeLicense
Dermatology primary207N00000X—
Dermatology, MOHS-Micrographic Surgery207ND0101X—
Dermatology, Dermatopathology207ND0900X—
Dermatology, Pediatric Dermatology207NP0225X—
Dermatology, Procedural Dermatology207NS0135X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.