National Provider Identifier Database

ORLANDO DERMATOLOGY CLINIC LLC
MOHS-Micrographic Surgery

The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.


Contact Information

ORLANDO DERMATOLOGY CLINIC, LLC
1040 LAKE SUMTER LNDG
THE VILLAGES, FL32162-2697
Phone: 352-218-3211
Fax: 877-699-3709
Website:
Specialty Taxonomy Code
* MOHS-Micrographic Surgery 207ND0101X
Dermatology 207N00000X
Dermatopathology 207ND0900X
Non-Pharmacy Dispensing Site 332900000X
Pediatric Dermatology 207NP0225X
Procedural Dermatology 207NS0135X

* Indicates primary specialty

NPI Profile & details for ORLANDO DERMATOLOGY CLINIC, LLC

NPI Number 1891257655
Legal business name
LBN
ORLANDO DERMATOLOGY CLINIC, LLC
Authorized official TAREK SHAATH - (DERMATOLOGIST, LLC PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/02/2019
Last updated 05/21/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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