OrganizationActive
Dermatologist LLC
NPI 1336899061 · MOHS-Micrographic Surgery Physician · Tampa, FL
Provider details
- NPI number
- 1336899061
- Entity type
- Organization
- Primary specialty
- MOHS-Micrographic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Olga Demidova, Director(216) 280-1343
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Dermatology Physician207N00000X
Allopathic & Osteopathic Physicians
Practice location
9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550
Phone: (440) 804-5996
Fax: (216) 758-4783
Approximate (ZIP-level) locationGet directions
Mailing address
9724 N Armenia Ave Ste 300
Tampa, FL 33612-7550
Registry dates
- Enumerated
- 2022-03-25
- Last updated
- 2026-06-04
- Certified
- 2026-06-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.