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

Galt Dermatology & Concierge Medicine PA

Organization Specialist · NPI 1780964460

Galt Dermatology & Concierge Medicine PA provides Specialist services in Fort Lauderdale, Florida. Licensed in Florida. Registered with an NPI since 2011.

Licensed in
FL
In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

800 E Broward Blvd Ste 103
Fort Lauderdale, FL 33301-2008
Phone: (954) 463-5406
Fax: (954) 522-2456
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence ME36538 (FL)

Record details

NPI number1780964460
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Miguel Villacorta — President · (954) 463-5406
Other names Galt Dermatology
NPI enumeratedAugust 25, 2011
Last updated in NPPESFebruary 28, 2025
Certification dateFebruary 28, 2025
Mailing address800 E Broward Blvd, Suite 103, Fort Lauderdale, FL 33301-2008

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