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

Countryside Dermatology and Laser Center Inc

Organization Dermatology Physician · NPI 1194914978

Countryside Dermatology and Laser Center Inc provides Dermatology Physician services in Clearwater, Florida. Licensed in Florida. Registered with an NPI since 2007.

Licensed in
FL
In the registry since
2007
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2467 Enterprise Rd Ste A
Clearwater, FL 33763-1724 Not confirmed with CMS for 18 years — call before visiting
Phone: (727) 791-1411
Fax: (727) 791-1419
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 46341 (FL)

Record details

NPI number1194914978
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Susan Roper — Owner · (727) 791-1411
NPI enumeratedOctober 17, 2007
Last updated in NPPESOctober 17, 2007
Mailing address2467 Enterprise Rd, Suite A, Clearwater, FL 33763-1724

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