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

Aqua Dermatology of Alabama PC

Organization Dermatology Physician · NPI 1477708642

Aqua Dermatology of Alabama PC provides Dermatology Physician services in Vestavia Hls, Alabama. Licensed in Alabama. Registered with an NPI since 2008.

Licensed in
AL
In the registry since
2008
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1940 Stonegate Dr Ste 130
Vestavia Hls, AL 35242
Phone: (205) 977-9876
Fax: (205) 977-9976
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

MOHS-Micrographic Surgery Physician (primary) Taxonomy 207ND0101X · Licence 20579 (AL)
Dermatology Physician Taxonomy 207N00000X · Licence 20579 (AL)
Procedural Dermatology Physician Taxonomy 207NS0135X · Licence 20579 (AL)

Record details

NPI number1477708642
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Karen Lake — Administration · (205) 977-9786
Other names Sunrise Dermatology; Surgical Dermatology Group; True Dermatology
NPI enumeratedDecember 1, 2008
Last updated in NPPESJune 25, 2024
Certification dateJune 25, 2024
Mailing address1940 Stonegate Dr Ste 130, Vestavia Hls, AL 35242-2541

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