Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Academic Alliance in Dermatology, PLLC

Organization Dermatology Physician · NPI 1215504154

Academic Alliance in Dermatology, PLLC provides Dermatology Physician services in Tampa, Florida. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4700 N Habana Ave Ste 303
Tampa, FL 33614-7118
Phone: (813) 341-3285
Fax: (813) 341-3284
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Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Dermatopathology Physician Taxonomy 207ND0900X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1215504154
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationAcademic Alliance in Dermatology, PLLC
Authorized official Nicole Proffitt — Director Of Enrollment & Credential · (804) 869-6269
NPI enumeratedJune 9, 2021
Last updated in NPPESSeptember 14, 2026
Certification dateSeptember 14, 2026
Mailing addressPo Box 23329, New York, NY 10087-3329

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