Wellformed AI

NPI 1669049615 · live from the CMS NPI Registry

Academic Alliance In Dermatology, PLLC

Dermatology in Tampa, FL. National Provider Identifier 1669049615, active.

NPI record

NPI1669049615 Type 2 · organization
StatusActive
Primary specialtyDermatology 207N00000X
Practice location13321 N 56th St, Tampa, FL 33617
Practice phone813-341-1488
Mailing addressPo Box 23329, New York, NY 10087
EnumeratedJune 8, 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.