OrganizationActive
Orlando Dermatology Clinic LLC
NPI 1609467109 · Dermatology Physician · Kissimmee, FL
Provider details
- NPI number
- 1609467109
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tarek Shaath, Owner(785) 760-6740
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(63/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2970 Loopdale Ln
Kissimmee, FL 34741-7658
Phone: (352) 218-3211
Approximate (ZIP-level) locationGet directions
Mailing address
1040 Lake Sumter Lndg
The Villages, FL 32162-2697
Registry dates
- Enumerated
- 2021-01-28
- Last updated
- 2022-11-03
- Certified
- 2022-11-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.